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Stress and Cortisol Elevated cortisol promotes fat storage, particularly visceral fat, and can override the metabolic benefits of Retatrutide

There's also the question of muscle mass

Journal of Autoimmunity

It is a chemically distinct, small-molecule compound that rewrites the rulebook for how GLP-1 weight loss therapy can be delivered

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Clinical studies on tirzepatide have shown average weight loss of 15 to 22 percent of body weight over 72 weeks