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(B) Semaglutide, as a GLP-1 analog, can directly act on fat cells, increase the expression of thermogenic genes for browning phenotype maintenance, improve the expression of uncoupling protein 1 (UCP1), mitochondrial biosynthesis, and thermogenic marker, or promote fatty browning through nitric oxide synthase (NOS), neuropeptides (NPs), sirtuin 1 (STRT1), signal transducer and activator of transcription 3 (STAT3), and bone morphogenetic protein 4 (BMP4) signaling

As most of them are patient-specific (503A), they are only allowed to compound on a much smaller scale, Semaglutide can only be compounded when it is on the short drug list, as it is now. However, the availability of both compounded semaglutide may be difficult with the FDA removing some name-brand medications from the shortage list

Cultural shifts may also be playing a role