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2.5 Mass Spectrometry Detection Detection of metabolites was performed using a Thermo Q Exactive Focusmass spectrometer (ThermoFisher Scientific, USA) with both positive and negative ESI models, respectively

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Of note, in STEP 3 intensive behavioral treatment was also administered in both arms, and in STEP 4 all patients were initially assigned to semaglutide 2.4 mg but were randomized 2:1 to semaglutide 2.4 or placebo after 20 weeks 25

The findings are presented here for completeness of the published evidence base

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