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Alternatively, as a gene-based therapy, the genetic components of the circadian sense-response system could be delivered to cells exposed to higher melatonin levels, such as those close to the pineal gland or cerebrospinal fluid, where melatonin levels can be up to 20 times higher than in the general circulation 63

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In the SURMOUNT clinical trial program for obesity, participants achieved average weight loss of 15-21% of body weight depending on dose, significantly exceeding results with diet and exercise alone or other available pharmacotherapies

doi: 10.1210/en.2007-1227 206 Diaz BrintonR