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Metabolic Resistance Point GLP-1 therapy is most strategically introduced when patients exhibit metabolic adaptations that counteract behavioral interventions: Plateau Effect: GLP-1 should be considered when patients adhering to a caloric deficit and exercise program experience a weight plateau, indicating a reduction in Total Daily Energy Expenditure (TDEE) as a physiological defense

This surgical modification results in varied outcomes, with post-surgical GIP levels either decreasing, remaining stable, or increasing