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They need exogenous insulin to survive

The MHRA has confirmed that retatrutide does not hold a UK marketing authorisation, and the risks of using unlicensed injectable compounds obtained outside approved trials are serious and cannot be fully mitigated by careful preparation alone

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Interestingly, this was also associated with greater weight loss in response to another weight loss drug, phentermine-topiramate, although it is not clear whether the correlation with weight loss was based on starting body weight or the impaired satiation (43)