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By increasing dopaminergic tone in limbic circuits, it elevates sexual desire and reduces inhibitory signals from serotoninergic systems

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This is followed by the release of nesfatin-1 which stimulates cholecystokinin secretion leading to a rise in bile salts from gallbladder emptying, and the binding of Takeda P protein coupled receptor 5 (TGR5) onto the surface of the enteroendocrine cells, all of which eventually culminates in GLP-1 secretion [9]

Retrieved October 17, 2016

doi: 10.1161/CIRCULATIONAHA.107.706416

This isn't a sign of treatment failure