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Figure 2 represents the pathophysiology of an altered IGF-1/GH/insulin axis, and potential beneficial actions of IGF-1 therapy

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B12 helps support brain function, and an imbalance may contribute to emotional changes or difficulties regulating mood

Another proposed mechanism involves competing interactions at growth factor receptor sites

When interpreted together with the findings of the STEP 4 withdrawal trial and STEP 1 off-treatment extension study, which both showed weight regain after semaglutide discontinuation (after 20 weeks treatment in STEP 4 and 68 weeks treatment in STEP 1) 23,24 , these results support the benefit of continued semaglutide treatment for sustained weight loss