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Existing reviews have further highlighted that pharmacokinetic and safety characterization in humans remains incomplete, complicating clinical counseling regarding timing of discontinuation, perioperative risk stratification, and postoperative resumption (Rahman et al

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The combination of all four pathways should theoretically produce earlier onset of appetite suppression, more sustained fullness between meals, increased resting energy expenditure from the glucagon component, and a reduced tendency toward the metabolic adaptation that commonly causes weight loss plateaus on single-agent therapy

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