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Medications such as metformin (used for diabetes), which interferes with vitamin B12 absorption

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This represents a key mechanism by which tirzepatide produces greater weight loss than diet alone despite similar caloric restriction

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The addition of glucagon receptor activation introduces direct thermogenic and lipolytic effects that neither GLP-1 nor GIP agonism provides alone, creating a mechanism that, in some ways, bridges the gap between the direct fat-targeting approach of AOD 9604 and the systemic metabolic reprogramming of tirzepatide