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SIRT3 expression is downregulated in obese patients, and deletion of SIRT3 leads to increased mitochondrial oxidative stress, reduced energy expenditure and worsened glucose metabolism, resulting in accelerated obesity under a high-fat diet (HFD) feeding [25, 26]

Conversely, patients who carry variants in hydroxysteroid 17-beta dehydrogenase 13 (HSD17B13, rs72613567) and mitochondrial amidoxime-reducing component 1 (MARC1, rs2642438) are more protected than the general population (48, 49)

The Precision Peptide Genetic Test ($99 add-on) identifies whether underlying genetic factors in FTO or MC4R pathways explain slower progress and may guide personalized protocol adjustments

This accessibility factor often translates to longer treatment durations in practice, which may partly explain why week-by-week results in real-world settings sometimes exceed clinical trial averages