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Answer: GLP-1 medications such as semaglutide and tirzepatide act on the GLP-1 pathway, while cagrilintide acts on the separate amylin pathway, which is why the two are additive rather than redundant when used together

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Most patients notice reduced appetite within days of starting semaglutide, making it psychologically easier to sustain the caloric deficit that metformin helps achieve through improved insulin function