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Metabolic Resistance Point GLP-1 therapy is most strategically introduced when patients exhibit metabolic adaptations that counteract behavioral interventions: Plateau Effect: GLP-1 should be considered when patients adhering to a caloric deficit and exercise program experience a weight plateau, indicating a reduction in Total Daily Energy Expenditure (TDEE) as a physiological defense

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Hypotheses include medication-related blood pressure changes, volume depletion from gastrointestinal effects, rapid glycemic improvement leading to transient vascular dysregulation, and altered autoregulation of optic nerve head perfusion

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