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While obesity is a primary driver of osteoarthritis and the need for joint arthroplasty, it also contributes to increased perioperative morbidity, higher infection rates, longer hospital stays, and worse long-term functional outcomes

The challenge, as with all approaches, is ensuring adequate protein intake when appetite is severely suppressed from both keto and GLP-1 simultaneously

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Altering the pharmacokinetic profile, even while maintaining the same total weekly dose, could theoretically affect receptor desensitization patterns, immune response to the peptide, or metabolic adaptation in ways that have not been characterized