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The oral route of drug delivery is challenging for peptides because the GI tract is specifically designed to break down proteins and peptides into their constituent amino acids for absorption

Eli Lilly, which makes Zepbound, has stated it is considering clinical trials to assess the drug as a treatment for substance use disorders, including alcohol and tobacco dependence

Furthermore, non-canonical routes to acetyl-CoA production outside of mitochondria have also been proposed, with several studies reporting a moonlighting function of the pyruvate dehydrogenase complex (PDC), which can translocate to the nucleus under specific conditions to generate a local source of acetyl-CoA from pyruvate for histone acetylation 1518

doi: 10.2147/IJN.S162087

Whilst pharmacological options may be appropriate in some cases, dietary and physical activity changes can achieve meaningful weight loss without the risks associated with medication and may directly benefit kidney health in the process