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While the sleeve provides a physical restriction and alters gut hormone profiles, these medications add an additional layer of appetite suppression and metabolic regulation

[The Working Group noted that a unique feature of this cohort was that its large size allowed restriction to never-smokers and stratification by sex

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From a theoretical pharmacological standpoint, combining a peptide with putative lipolytic activity (AOD 9604) with a potent triple incretin receptor agonist (retatrutide) could potentially amplify metabolic effects but this is speculative and raises the possibility of compounding adverse effects with no safety data to guide dosing or monitoring

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