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Tesamorelin has human evidence for reducing visceral and liver fat through pulsatile growth-hormone release, so it fits a transition where waist, visceral-fat, or liver markers are rebounding. MOTS-c activates the same cellular energy sensor that responds to exercise, making it a mechanism-based fit when training output, fatigue, or insulin sensitivity worsens. The MOTS-c evidence does not establish clinical efficacy after retatrutide