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Equine Vet J.1995;27(3):183-191
The double mechanisms makes Zepbound more effective at weight loss than the single mechanism of action GLP-1s such as Saxenda and Wegovy

GLP-1 Medical Weight Loss and BioTE Bioidentical Hormone Replacement Therapy
The bigger issue is indirect, if a supplement worsens nausea or reflux, it can make it harder to stay consistent with meals and hydration, which then makes everything feel worse

It just gets smaller and smaller until the amount is pharmacologically irrelevant
