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Mechanisms include reduced gallbladder contractility and supersaturation of bile with cholesterol during rapid fat mobilization

Incretin mimetics have demonstrated safety and efficacy in advanced kidney disease, however multiple studies have shown that use of GLP1-RA have shown improvements in glycemic control, body weight reductions, improved beta cell function, and decreased incidence hypoglycemia as compared to DPP4i in a general diabetes population 26,27,28,29,30,31 , effects which might explain the reduction of acute healthcare utilization observed in this study of patients with CKD treated with GLP1-RA as compared to DPP4i

2023 Aug;47(8):677-685

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It doesnt directly act on estrogen or other reproductive hormones

The most prevalent side effect of Exenatide is nausea, which may explain its weight loss effects [227]