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2024;57(5):987–1004.e5

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A single molecular entity simultaneously activates both the GLP-1 receptor and the amylin receptor (calcitonin receptor complex), combining two complementary satiety and metabolic pathways: GLP-1 receptor activation : Glucose-dependent insulin secretion, glucagon suppression, delayed gastric emptying, and central appetite reduction through hypothalamic signaling Amylin receptor activation : Additional satiety signaling through the area postrema, complementary gastric emptying delay, and glucagon suppression through a distinct mechanism The unimolecular design means both receptor activations occur at a fixed ratio determined by the molecular structure