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It works by mimicking the action of the GLP-1 hormone, which is released in the gut

After adjusting for age, body mass index (BMI), disease severity and other health factors, GLP-1 users still showed significantly lower odds of death, suggesting a strong and independent protective effect

however, additional studies are needed to confirm causation

Although not thought to be directly influenced by obesity, lipoprotein (a) is an independent risk factor for cardiovascular disease that is determined by genetics

doi: 10.1177/20503121241253957, 5

"Elevated methylmalonic acid is related to cognitive impairement in older adults enrolled in an elderly nutrition program"