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Mitch Biermann, an internal and obesity medicine specialist at San Diegos Scripps Clinic

1996 (multicenter trial): A larger multicenter, randomized, double-blind, placebo-controlled study enrolled 431 patients with mild to moderate probable Alzheimer's disease, administering 3 g/day of ALCAR for 12 months

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Bariatric surgery: Reduces absorptive surface area Bypasses sections of intestine Requires mandatory supplementation GLP-1 therapy: Preserves intestinal anatomy Does not bypass nutrient transporters Alters appetite rather than anatomy The mechanisms differ fundamentally

gradual titration minimizes severity [3]