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At the same time, payer policies often require discontinuation of GLP-1 therapy when a patients BMI drops below a set threshold, inadvertently triggering a frustrating cycle of weight loss and regainthe so-called yo-yo effect. This not only impacts ongoing adherence and persistence but also undermines the long-term cost-effectiveness of these therapies for healthcare systems

The anti-obesogenic effect of GLP-1RAs is mediated by direct inhibition of the feeding center and indirectly through modulation of energy expenditure (Jepsen and Christensen 2021)