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The sagging skin occurs because weight gain makes it hard for the skin to stay firm as it damages elastin and collagen in the skin

in Cell Metabolism (2020), tirzepatides dual agonist action enhances glucose-dependent insulin secretion from pancreatic beta cells, reduces glucagon secretion from alpha cells, and slows gastric emptying

For manufacturers, this shift opens new competitive battlegrounds, where efficacy, tolerability, and pricing strategies will determine leadership in a new market dimension

Other health systems pursuing similar models include Mass General Brigham, Cleveland Clinic, and Karolinska in Europe