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Significance statement ![Figure][1] ### Competing Interest Statement The authors have declared no competing interest

GLP-1 RAs provide sustained central and peripheral GLP-1R activation that blunts appetite via hypothalamusvagusNTS circuits, improves metabolic health, and may reduce alcohol and other substance-related craving and reward signals.

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Grading of Recommendations Assessment, Development and Evaluation (GRADE) showed moderate certainty for MACE, all-cause death and hospitalization for HF