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Interestingly, pioglitazone can actually encourage the creation of new, smaller fat cells

GLP-1s work best in conjunction with holistic behavioral change programs: Supplementing GLP-1 use with holistic lifestyle and nutrition behavioral change management programs likely achieves the largest and most sustainable clinical benefit and cost savings, and helps overcome adherence challenges

This distinguishes it from GLP-1 medications, which in some patients have been associated with significant lean mass reduction alongside fat loss