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Estrogen can also impact mitochondrial biogenesis, function, and regulation of ATP production.[ref] In a nutshell, estrogen causes the body to increase the production of other hormones, growth factors, and metabolic factors

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The GIP component adds another layer

The risk-benefit calculation tips toward unopposed estrogen in this group

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If the remaining Phase 3 readouts hold and the FDA filing proceeds on the projected late- 2026 timeline, retatrutide is positioned to arrive as the unambiguous class leader and the first obesity drug whose efficacy curve starts to genuinely overlap with bariatric surgery