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No regulatory agency, and no peer-reviewed publication, has explained why

Actually, Mark Mattson just published a study very recently

16 NRF2 Pathway NRF2 is an important transcriptional regulator of anti-ferroptotic genes and is itself regulated by enzymes such as KEAP1

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However, in our mutant mice, an elevation in p62 levels was observed in SN TH cells of both HOMO and HET mice while the expression of LAMP1 was reduced in HOMO mice

Patients should be counseled that sustainable weight management requires long-term commitment to lifestyle changes, and medication is an adjunct rather than a replacement for healthy behaviors