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The key difference is that retatrutide provides triple agonism (GLP-1 + GIP + glucagon) while semaglutide provides only GLP-1 agonism

During exercise, skeletal muscle produces BDNF and releases lactate into the bloodstream, which crosses the blood-brain barrier and triggers additional BDNF expression in the brain

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ProCNP and CNP are expressed primarily in male genital organs

Furthermore, during IR, peripheral tissues experience reduced insulin sensitivity, while hepatic very low-density lipoprotein(VLDL) levels rise, contributing to disruptions in hepatic lipid metabolism (189)