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It is a synthetic 39-amino-acid molecule that activates three metabolic receptors GIP, GLP-1, and glucagon through one compound

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Some complaints also include eye-related allegations, including non arteritic anterior ischemic optic neuropathy claims and, in some reports, references to arteritic anterior ischemic optic events, which involve compromised blood flow to structures in the eye

They act on different receptors, through different pathways, with different effects on the growth-hormone pulse which is precisely why they're so often studied together rather than chosen one over the other