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I felt stuck, uncomfortable in my body, and discouraged, especially after being dropped from another weight loss program because of my age

Central GLP-1 plays a crucial role in regulating appetite, stress responses, and glucose homeostasis [13,14]

Metformin suppresses hepatic gluconeogenesis via AMPK activation, [6] while GLP-1 receptor agonists enhance glucose-dependent insulin secretion and promote satiety, improving both fasting and postprandial glycaemic control

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The fixed-effect sensitivity analysis preserved the overall directional ordering, supporting the robustness of the main interpretation (Supplementary Appendix 6)