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However, drastic changes in body composition can also lead to low estrogen levels, which may temporarily disrupt ovulation

Patients treated with tirzepatide lost an average of 21.1% of their body weight since randomization (co-primary endpoint), compared to an average weight gain of 3.3% over 72 weeks for patients treated with placebo, for a placebo-adjusted net weight change of -24.5%

In some of them, their fat cells are insulin resistant, too, so energy doesnt accumulate in the subcutaneous tissue