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And perhaps most relevant to this combination, hunger hormones, particularly ghrelin, tend to decrease in ketosis, reinforcing the appetite suppression that semaglutide is already creating through a completely separate pathway

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Eli Lilly: multi-agonist leadership (tirzepatide, retatrutide) + a strong oral candidate (orforglipron), best-in-class efficacy but gastrointestinal side effects remain a challenge

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