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Exchange factor directly activated by cAMP (Epac) upregulates expression of the negative leptin signaling modulators SOCS3 and PTP1B, whereas inhibits the positive modulators STAT3 and S6K1, impairing the leptin signaling cascades in hypothalamic neurons [213, 214]

doi: 10.1016/j.molmet.2015.07.008

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Pharmacotherapy alternatives such as liraglutide can help, though they are slightly less effective for weight loss