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The combination of behavioral therapy and the magnitude of change makes this a signal worth paying attention to, even with the study constraints.

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It does not provide medical advice, recommend schedules, prescribe medication, create protocols, manage semaglutide use, adjust medication, or replace instructions from a licensed healthcare professional or product label

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Cohort achieved 9% weight-loss

The deficit from the peptide plus training stress plus life stress plus insufficient sleep creates a feedback loop: poor sleep raises cortisol, which disrupts sleep further, which raises cortisol more