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"When access to these medications is denied, the consequences can be immediate: continued weight gain or regain, increased frustration and the psychological impact from appetite rebound." Alternatives when GLP-1s are not available or affordable Many health care providers continue to counsel their patients to follow a variety of lifestyle adjustments that can have a positive impact on health and weight over time

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In the following part some of the postulated pathways that might contribute to the impaired glucose homeostasis will be briefly discussed