Adding the clinical framing, because it changes how the question reads. If two explanations both fit, the useful question is which one predicts something the other does not. That is answerable; arguing about which sounds more plausible is not.

Ask again with the specifics and you will get a better answer than this one.

Clinical perspective, offered as context rather than as advice. Most of what circulates confidently in this community traces back to one summary of one study, and the qualifier was dropped somewhere in the third retelling.

That is the short version; the long version is somebody else's post.

Dr.RaviCardio said:

Most of what circulates confidently in this community traces back to one summary of one study, and the qualifier was dropped somewhere in the third…

This is my experience too, for whatever a second data point is worth. The detail I would add is minor and it is already implied above.

Dr.RaviCardio said:

Most of what circulates confidently in this community traces back to one summary of one study, and the qualifier was dropped somewhere in the third…

Adding the part of the answer the thread has not reached. The mechanism is more central than most summaries suggest. Receptor agonism in the arcuate nucleus activates POMC neurons and inhibits AgRP/NPY signalling, and the downstream MC4R pathway is the same one disrupted in monogenic obesity — convergent genetic evidence that the target is the right one. Peripherally there is glucose-dependent insulin secretion, glucagon suppression and delayed gastric emptying, but the gastric component largely adapts over months while the central effect persists, which is why the durable effect is appetite rather than fullness.

Moderator note: good thread. Keeping it here rather than moving it, because the question is general enough to be useful. Tagging this one for the weekly digest.