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The GLP-1 medication semaglutide has been shown to be effective and safe across a broad population of people with overweight and obesity, leading to 10-20% weight loss which is usually needed to see the benefits

Incretin analogues also show beneficial effects in heart failure, peripheral vascular disease, renal disease, obstructive sleep apnoea and metabolic dysfunction-associated steatohepatitis and have potential neuroprotective properties

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The biggest offenders contain either high concentrations of sulfur amino acids or sulfur-containing organosulfur compounds that gut bacteria readily metabolize

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The clinical consensus is that if semaglutide alone isn't working, dose escalation or genetic testing to find alternative compounds (such as tirzepatide) is safer than adding a second drug class