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It is possible that the placebo effect may be enhanced in our study due to the shared decision-making process, whereby patients receive lifestyle advice and increased attention from their treating clinician, which may result in favourable behavioural changes [48]

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What remains unknown Despite encouraging data, genuine unknowns exist: Effects beyond 6-9 months of continuous use have not been formally studied in animals or humans

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Maarbjerg and Jeanett Borregaard were employees of Novo Nordisk A/S at the time of conduct of the trial and preparation of this manuscript and are shareholders of Novo Nordisk A/S (current affiliation of SJM: Zealand Pharma A/S, Sborg, Denmark

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