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The STEP 5 trial demonstrated that continued treatment for 104 weeks maintained weight loss, while the STEP 1 extension study showed that discontinuing semaglutide at 68 weeks led to two-thirds of the weight lost being regained within a year

in Cell Metabolism , increased NAD availability stimulates PGC-1 through SIRT1 activation, leading to enhanced mitochondrial function and improved metabolic flexibility (Cant et al., Cell Metabolism )

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And with a November due date, I knew I was in for a one-two punch