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Some patients who have successfully adopted sustainable dietary changes, regular physical activity, and behavioral strategies may maintain a portion of their weight loss

Oxidative stress is a potent, direct trigger for mast cell degranulation

Tornehave et al., 2008) (Figure 1)

Benefits observed in trials with weekly semaglutide monotherapy include: 20% reduction in MACE incidence versus placebo Lower blood pressure and improved systolic readings Improved lipid panels: lower triglycerides, modest LDL effects Early separation of event curves by ~20 weeks 20% lower all-cause mortality in treated group These points show that semaglutide acts on multiple pathways: fat loss, metabolic change, and likely direct cardiovascular effects

After four weeks, patients increase to 0.5mg weekly for another four weeks, then to the maintenance dose of 1mg or 2mg weekly depending on response and tolerance