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Mental stress should be addressed among individuals with obesity, as chronic stress may promote obesity development through the sympathetic nervous system and hypothalamic-pituitary-adrenal axis activation that elevates cortisol levels, interferes with insulin sensitivity, promotes energy storage, and creates food cravings for ultraprocessed comfort foods 189 GLP-1s may act both centrally and peripherally to reduce these downstream impacts of chronic stress and obesity and alter food reward pathways in positive ways

Subgroup analyses by drug type, duration of treatment, and patient characteristics similarly showed no concerning signals

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