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The mechanisms underlying weight regain are multifactorial and include metabolic adaptation with decreased energy expenditure, hormonal changes affecting appetite regulation, anatomical alterations such as gastric pouch or stoma dilation, and psychosocial factors including maladaptive eating behaviors
Ethics declarations Ethics approval and consent for publication The present study was approved by the CPRD Research Data Governance (#23_002545), the Research Ethics Board of Sunnybrook Health Sciences Centre (PIN: 6013), and the Research Ethics Board of University of Toronto (#46463)
Compared to GLP-1 medications costing $800-$1,500 per month without insurance, the supplement is significantly cheaper but also produces significantly more modest and variable results
Both drugs also significantly reduced the risk of persistent eGFR reductions of 40% and 50%, while showing similar trends for 30% and 57% reductions
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