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Additional research has focused on the relationship between NNMT activity and nicotinamide metabolism, methyl donor utilization, and cellular signaling networks associated with energy balance

A second family, BPC-157 and TB-500, targets tissue repair rather than the GH axis: BPC-157 is proposed to work through angiogenesis, nitric-oxide signaling, and anti-inflammatory activity, while TB-500 binds actin to promote cell migration, blood-vessel formation, and collagen deposition

Whilst neurobiological mechanisms suggest plausible pathways through which these medicines might influence appetite and reward processing, definitive evidence remains limited

Up until now, the supply has been a challenge. For years in Louisiana, doctors had been banned from treating obesity via telehealth under old state regulations that targeted the prescription of certain stimulants, like the appetite suppressant phentermine, a controlled substance that has the potential for abuse or addiction

More serious but rare adverse events include pancreatitis (0.2% incidence), gallbladder disease requiring surgical intervention, and medullary thyroid carcinoma risk in genetically predisposed individuals (contraindicated in patients with personal or family history of MTC or MEN2 syndrome)

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