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Potential indirect mechanisms that could theoretically influence libido include: Nutritional deficiencies if caloric restriction is excessive Fatigue or low energy during the initial treatment phase Hormonal fluctuations associated with adipose tissue loss Psychological adjustment to body image changes Patients should be reassured that sexual side effects are not a recognised feature of Wegovy therapy, but any persistent concerns warrant clinical evaluation to exclude other contributing factors

Furthermore, gut microbiota modulation through dietary interventions, probiotics, drugs, or fecal microbiota transplantation, has shown promising results in various conditions, including inflammatory bowel disease (Li et al., 2021b), colorectal cancer (Wong and Yu, 2019

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Levit, MD, Guest Editor, for review by expert referees, editorial decision, and final disposition

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Lipid metabolism support Semaglutide itself improves lipid profiles