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If you use sterile water instead, you lose that protection entirely

Exendin-4 is a 39-amino-acid polypeptide (48-86) and a long-acting glucagon-like peptide-1 (GLP-1) receptor agonist with an IC 50 of 3.22 nM [1]

"Wegovy in a pill basically will have the same efficacy as its injectable counterpart