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The GIP component enhances fat metabolism and reduces hepatic glucose output, mechanisms that single-agonist GLP-1 drugs dont address

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Research suggests several beneficial mechanisms: Improved insulin sensitivity : Insulin resistance is a key driver of PCOS symptoms, and GLP-1 medications can enhance insulin action Weight loss effects : Even modest weight reduction (510% of body weight) can restore ovulation and regular cycles in women with PCOS [17] [18] Reduced androgen levels : Weight loss and improved insulin sensitivity often lead to decreased testosterone and other androgens Restoration of ovulation : Some women with PCOS who previously had absent periods may begin ovulating regularly NICE Clinical Knowledge Summary on PCOS recommends lifestyle modification and weight loss as first-line interventions for overweight women with the condition

Acknowledgements We thank Umut Erhan, Azadeh Houshman-regaard and Anders Strathe of Novo Nordisk A/S (Denmark) and Zu Ning of Novo Nordisk China A/S (China) for their contributions to the manuscript