High stress levels, especially chronic psychological stress, can lead to physiological changes that reduce the effectiveness of GLP-1 receptor agonists (GLP-1 RAs) like semaglutide or liraglutide, commonly used in managing type 2 diabetes and obesity. A key biomarker of chronic stress is cortisol, a hormone secreted by the adrenal glands in response to stress via the hypothalamic-pituitary-adrenal (HPA) axis.