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As NAD+ levels decline with age, obesity, and metabolic disease, sirtuin function diminishes, contributing to insulin resistance, mitochondrial dysfunction, and fat accumulation

For instance, the American Diabetes Association only recommends the use of GLP-1 drugs for weight loss for those with a body mass index, or BMI, of at least 30, or among those with a BMI of 27 or greater if they have at least one other condition such as type 2 diabetes, hypertension or high cholesterol

"We know that semaglutide is most effective when it's accompanied by exercise, ideally a minimum of thirty minutes a day," Dr