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The proposed pathway is restoration of pinealocyte function either by direct gene-regulatory effects on serotonin-N-acetyltransferase (AANAT) and related enzymes, or indirectly by reducing neuroendocrine stress signalling
It usually produces less weight loss than tirzepatide, but it has the longest outcomes record in the class: fewer cardiovascular events, slower kidney decline, and years of diabetes-trial safety data
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For comparison, the average bariatric surgery patient loses about 25-to-35% of their body weight
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