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Semaglutide works by slowing stomach emptying and reducing appetite signals in the brain, which means your digestive system becomes more sensitive to what you consume

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10.1016/j.jneuroim.2015.05.007 40

Emerging evidence from genome-wide association studies (GWAS) and epidemiological research has linked the C677T polymorphism in the gene encoding the folate-metabolising enzyme MTHFR with an increased risk of hypertension and HDP by up to 87 %, as mentioned earlier in this review (Reference Qian, Lu and Tan15Reference Yang, Fan and Zhi18)

This can result in reduced efficacy, meaning you inject what you think is 5 mg but get the biological activity of substantially less

Weight loss with semaglutide pills: 13.6% Individual results vary