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However, clinical studies have shown that treatment with leptin or its analogues does not significantly affect body weight, fat mass, glucose and insulin homeostasis, lipid profile, or food intake in individuals with obesity compared to placebo [76,77,78,79]

This is because the vasodilatory effects of GLP-1 receptor activation and the blood volume reduction from weight loss more than compensate for the increased cardiac output

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Response: We remain committed to the Excessive Radiation eCQM as a patient safety issue and affirm, as we did in the CY 2024 OPPS/ASC final rule (88 FR 81987), that the measure's data elements are scientifically and practically valid