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A combined effect that is bigger than just decreasing calories is thought to be at play when looking at the effects of activating the GLP-1 receptor.[ref] In overweight adults aged 45+, a 4-year-long study using semaglutide for weight loss also prevented HbA1c from rising over time, which was seen in the placebo arm

Hepatic steatosis in obese patients: clinical aspects and prognostic significance

Nephron Clin Pract 97:4148 Spagnoli LG, Palmieri G, Mauriello A, Vacha GM, DIddio S, Giorcelli G, Corsi M (1990) Morphometric evidence of the trophic effect of l-carnitine on human skeletal muscle

Physiol Rev 83:731801 Attaix D, Combaret L, Kee AJ (2003) Thaillandier D (2003) Mechanisms of ubiquitination and proteasome-dependent proteolysis in skeletal muscle