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Additional Cases Reported in the Literature Three published case reports describe patients who followed a recommended fasting protocol 4,5 but had residual food or fluid in their stomach at the time of the procedure

383,384 Importantly, the activation of AMPK reduces the expression of phosphoglycerate mutase 5 (PGAM5), which plays a promotive role in cell necrosis by contributing to mitochondrial dysfunction and the production of reactive oxygen species (ROS)

Serious side effects: pancreatitis, gallbladder disease, acute kidney injury, hypoglycemia (especially with insulin), severe allergic reactions

[3] In SURMOUNT-1, tirzepatide produced larger mean weight loss again, but not uniformly

Xin Lu, [email protected] These authors have contributed equally to this work ORCID: Zixuan Hu, orcid.org/0009-0000-7508-5457

Obes Rev (2019) 20:80515