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A subsequent study of PF-05231023 did not demonstrate weight loss, and there were no changes observed in markers of bone formation or resorption, IGFBP13, or free IGF1 (293)

Certain foods and gut bacteria may also play a role

Clinical approach recommendations include starting with the most conservative effective therapy, optimizing tirzepatide dosing before adding other agents, regular monitoring of cardiovascular parameters and metabolic markers, and setting realistic weight loss goals (5-10% initial target)