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Key mechanisms include: Activation of neurons in the area postrema and nucleus tractus solitarius in the brainstem Enhanced satiety signaling through distinct pathways from GLP-1 mechanisms Slowed gastric emptying via calcitonin receptor-mediated effects Reduced food reward signaling and decreased food noise through central appetite centers Studies in knockout mouse models confirmed that cagrilintides weight loss effects depend specifically on AMY1R and AMY3R presence, demonstrating receptor-specific mechanisms

(2017) 313:L278l92

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Furthermore, Glu is converted to -ketoglutarate, an established anabolic agent [39]

If IGF-1 rose 20%+ and fasting insulin is still below 8, the protocol is working without metabolic cost