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Chronic conditions or surgical recovery often run up to 6 weeks , then shift into tapering or maintenance

The combination of all four pathways should theoretically produce earlier onset of appetite suppression, more sustained fullness between meals, increased resting energy expenditure from the glucagon component, and a reduced tendency toward the metabolic adaptation that commonly causes weight loss plateaus on single-agent therapy

Both have limited data in severe hepatic impairment

JPHW consults widely for pharmaceutical companies in relation to obesity and diabetes (fees paid to the University of Liverpool) and via his institution has received research grants from industry