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and Munford, R.S

This 26-hour minimum is the driving factor, as the intensity (or dose) of IHBLT is measured in face-to-face patient contact hours, and the number of hours is directly proportional to the reduction in BMI

However, various internal and external factors can disrupt this balanced distribution, causing melanin to accumulate in specific areas and creating the characteristic dark spots associated with hyperpigmentation

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Neuroreport 17(17):18031806

In the SURMOUNT-4 trial, withdrawing tirzepatide after initial weight loss led to weight regain, while continued treatment maintained and extended weight reduction