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As a result, the brain releases more of the hunger hormone ghrelin and dials down leptin, one of the hormones that signals fullness and energy sufficiency

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- **Clinical outcomes**: Progress notes should track changes in exercise capacity, symptoms, and hemoglobin levels to justify continued or repeat courses

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The SURMOUNT trial program, which is the largest clinical trial series evaluating tirzepatide for obesity, has produced results that have reshaped how clinicians think about medically supervised weight loss