Inclusion Criteria:  Diagnosed with schizophrenia spectrum disorder (ICD10 codes DF20, DF21 or DF25) Age between 18 and 40 years (both included) Approved contraception for female participants Treated by one of the OPUS clinics and or community psychiatry centers teams and community psychiatry in the Region of Southern Denmark or Zealand Antipsychotic SGA treatment for at least 6 months Stable co-medication for at least 1 month HbA1c between 39-47 mmol/mol (both included). Two measurements with ≥3 month interval are required to confirm prediabetes. The first measurement is identified and obtained from patient journals, the second prior to enrolment BMI ≥27 kg/m2. Two weights with ≥3 month interval are required to confirm obesity Capable of providing informed oral and written consent  Exclusion Criteria:  Diagnosis of diabetes (T1D or T2D) or a HbA1c >47 mmol/mol Active malignant disease within the last 5 years Pregnancy or breast feeding Exceeding high risk consumption limit (>21 / 14 units of alcohol for men / women, respectively) or severe substance abuse Unwillingness to allow home visits by a study nurse Significant somatic disease: 1) end-stage renal failure (eGFR <15 ml/min); 2) elevated liver function tests (liver transaminases >2 times upper normal limit); 3) history of acute or chronic pancreatitis; 4) heart failure (NYHA class IV) or unstable angina pectoris or myocardial infarction with the last 6 months; 5) uncontrolled hypertension (systolic blood pressure >180 mm Hg, diastolic blood pressure >100 mm Hg) Previous treatment with study drug or use of other weight reducing drugs within the last 6 month Participation in other drug trials Treatment with drugs approved for overt diabetes type 2. (Metformin not included) Circumstances that the investigator believes will interfere with the trial