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There has been a lot of discussion around ectopic fat being an inflammatory milieu, but there can also be mechanical effects that play a role

From an employer perspective, covering these drugs could help prevent complications from obesity

AOMs that mimic glucose-dependent insulinotropic polypeptide (GIP) Due to the relatively weak insulinotropic effect observed in patients with T2DM, in addition to the preclinical data on GIP receptor (GIPR) agonism in mice with diet-induced obesity, the use of GIPR agonists (GIPRAs) for the treatment of T2DM and obesity was initially viewed with skepticism (74)

You may not be losing weight on semaglutide because your body has adapted, your calorie needs have changed, muscle mass has declined or underlying medical factors are affecting progress