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These findings are consistent with a 15-year case-controlled study in patients where it was shown that carriers of heterozygous variants of LEPR had a good initial response to RYGB surgery but then suffered from marked weight regain compared to noncarriers of such variants (1230)

Genetic mutations in humans as well as in animals that disrupt the expression and processing (this includes the proteases that process the POMC precursor) of POMC peptides and MCRs are associated with changes in energy balance and can lead to obesity and type 2 diabetes

Extended exposure to heat degrades the tirzepatide peptide chain faster than it affects the pyridoxine, so the tirzepatide stability is the limiting factor