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The metabolic benefits may not require achieving maximum weight loss if body composition outcomes are prioritized

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This mechanism includes the inhibition of hepatic glycogen synthesis, the enhancement of hepatic gluconeogenesis, excessive production of branched-chain amino acids (BCAAs) that block insulin receptor substrates, the generation of dipeptidyl peptidase-4 (DPP4) which accelerates degradation of glucagon-like peptide-1 (GLP-1), thereby reducing GLP-1-mediated insulin secretion, and the induction of -cell dedifferentiation, which alters insulin production

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