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Participants with the highest body mass index (BMI) values (40 or above) were most likely to access semaglutide, which is not surprising given that this group has the highest risk for developing further metabolic diseasebut Podolsky says it reflects a trend that physicians may be restricting GLP-1 drugs to patients with the highest weight, and solely recommending lifestyle interventions to patients with BMI values of 35 or less

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In addition, tryptophan and tyrosine are metabolized by gut microbes to indole and p-cresol, respectively, which are then metabolized by human cells to the protein-bound uremic toxins indoxyl sulfate and p-cresyl sulfate