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However, the inclusion of these agents did not substantially alter the rates of the pooled effect estimate, but the results should be interpreted with this in mind

Substantially longer than GHRP-6 and GHRP-2s 1560 minute half-lives

If they are not losing as much or having a lot of cravings, something like Contrave, Naltrexone or Topiramate could be added as standalone medications. However, if youve managed all the variables, are layering medications, and the patient is still not making sufficient progress, then a bariatric procedure should be part of the conversation