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“We tried the mono agonists available on the European market at that time, which were dulaglutide, liraglutide, and semaglutide,” he explains, “but hyperphagia was unaffected and body weight only temporarily mildly dipped and eventually stagnated.” Scherer explains that the situation was particularly critical for one of the men who was experiencing obesity-related metabolic complications including MASLD, dyslipidemia, and type 2 diabetes requiring insulin doses greater than 100 IU/day despite maximal antidiabetic therapy with metformin 1,000 mg bid, dapagliflozin 5 mg bid, pioglitazone 45 mg qd, and semaglutide 1 mg once weekly