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Summary: Weight loss plateaus with Wegovy commonly occur due to metabolic adaptation, dietary adherence changes, fluid retention, underlying medical conditions, or medication interactions, rather than treatment failure

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Increased saccharopine and -aminoadipic acid levels, along with the saccharopine/lysine ratio, indicate enhanced saccharopine pathway activity

By lowering plasma glucose through renal excretion and modestly increasing circulating ketone availability, SGLT2 inhibitors shift systemic and cerebral energy metabolism away from exclusive dependence on glucose [27]

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