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It further suggests that disruption of hypothalamic pathways involved in appetite and energy homeostasis may result in alterations in other pathways such as GLP-1-mediated signaling in the brainstem, which remain intact in HO patients

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Am J Physiol Regul Integr Comp Physiol 284 , R14271435, (2003)

Exercise is your most powerful tool for maintaining metabolic rate and managing appetite once the medication is gone

GLP-1 also slows down the emptying of the stomach so that glucose stays in the stomach longer