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These combined effects lead to improved glycaemic control and significant weight reduction

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Pharmacogenomics of Medication-Induced Weight Gain and Antiobesity Medications

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Based on early human studies and animal research, GLP-1 agonists may affect: Reward-related eating behaviours by potentially modulating dopamine signalling in brain reward circuits Food cravings and hedonic eating (eating for pleasure rather than hunger) Impulsivity around food , possibly reducing the compulsive aspects of eating Satiety signalling , enhancing the feeling of fullness after meals Some patients using GLP-1 medications for diabetes or weight management report not just reduced appetite but also diminished preoccupation with food, fewer intrusive thoughts about eating, and reduced cravings for specific foods, particularly those high in fat and sugar

Thus these changes must come from some other effect of chromosome 21 trisomy