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Custom codes are available on request from the authors

For patients already on metformin, adding a dual-compound GLP-1 therapy provides three distinct mechanisms: hepatic glucose reduction (metformin), appetite and satiety control (both GLP-1 and GIP pathways), and enhanced pancreatic insulin secretion (particularly robust with tirzepatide)

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Patients who neglect protein while on semaglutide often lose muscle alongside fat, slowing metabolism and creating a weaker physique

After a 10 percent weight loss, total energy expenditure typically declines by approximately 15 percent, meaningfully more than the change in body mass alone would account for

Both treatments demonstrate their pros and cons