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Article History

Received: 23 January 2025

Revised: 27 July 2025

Accepted: 4 September 2025

First Online: 16 September 2025

Competing interests

: RFK has received grant support from Epitomee Medical Ltd, received consulting fees from Novo Nordisk, Eli Lilly, Boehringer Ingelheim, Structure, Altimmune, Regeneron, Currax, and Weight Watchers, and holds a voluntary committee membership position at the American Diabetes Association. JDA has received grant support from Nestle Healthcare Nutrition, Eli Lilly, Boehringer Ingelheim, Epitomee, Inc., UnitedHealth Group R&D, KVKTech, and WW, consulting fees from Nestle Healthcare Nutrition, Eli Lilly, Optum Labs R&D, Novo Nordisk, Intuitive, Regeneron, Brightseed, Level2, WW, Amgen, and Boehringer Ingelheim, receipt of equipment, materials, drugs, medical writing, gifts or other services from KVKTech, WW, and Nestle Healthcare Nutrition, and serves as President of The Obesity Society and an Executive Board Member for the American Society for Nutrition Foundation. TAW has received grant support, on behalf of the Trustees of the University of Pennsylvania, from Eli Lilly, Epitomee Medical, and Novo Nordisk, and has served on scientific advisory boards for Eli Lilly, Novo Nordisk, and WW. PMO has received grant support from Epitomee Medical Ltd, Novo Nordisk and Eli Lilly, consulting fees from Novo Nordisk, participated on an advisory board for Novo Nordisk, and has an unpaid leadership or fiduciary role for the Diabetes Initiative of South Carolina. HEB has received grant support from 89Bio, Alon Medtech/Epitomee, Altimmune, Amgen, Bioage, Boehringer Ingelheim, Carmot, Chorus/Bioage, Eli Lilly, Evidera, Kallyope, Novartis, NovoNordisk, Pfizer, Regeneron, Satsuma, Selecta, Shionogi, Skye/Birdrock, Veru, Viking, and Vivus, consulting fees from 89Bio, Altimmune, Amgen, Boehringer Ingelheim, Kiniksa, HighTide, Lilly, Novo Nordisk, Regeneron, Veru, Zomagen, and ZyVersa, participated on an advisory board for Epitomee, Altimmune, Novo Nordisk, Boehringer Ingelheim, and Kiniksa, and serves as Chief Science Officer and President-Elect of The Obesity Medicine Association. FLG has received grant support from Epitomee Medical Ltd, consulting fees from Altimmune, DexCom, Basic Research, and NovMeta Pharma, support for meeting attendance from BioHaven, holds patents issued or pending (US 11,534,442, US 11,058,662, US 10,897,921, US 10,507,194, US 9,999,601, US 8,334,000, US 7,709031, US 17/245,538, and US 15/565,367), and stock or stock options from Pep—19, Slim Health Nutrition, Rejuvenate Bio, Energesis, Ketogenic Health System, GATC Health, and Uplifting Results Inc. JMJ has received grant support from Epitomee Medical Ltd and the National Institutes of Health, consulting fees from Scientific Advisory Committee for Wondr Health, Inc., and holds a volunteer leadership position at the American College of Sports Medicine. HRW has received grant support from Epitomee Medical Ltd, General Mills, Novo Nordisk, Gelesis, and the National Cattleman’s Beef Association, royalites or licenses from State of Slim (book), IP owned by Shakabuku, and IP licensed to University of Colorado, consulting fees from Gelesis, honoraria from the Cardio Metabolic Health Conference and the Institute for Medical and Nursing Education, holds a patient issued or pending for Energy Gap, and holds stock or stock options for Shakabuku LLC (equity ownership interest), Dr Holly LLC (equity ownership interest), and Roman Health. YK is an employee of Epitomee Medical Ltd and holds stock or stock options. Liora Cohen Asaraf is an employee of Epitomee Medical Ltd and holds stock options. DHR has received consulting fees from Altimmune, Amgen, Astra Zeneca, Biohaven, Boehringer Ingelheim, Calibrate, Carmot/Roche, CinRx, Currax, Epitomee, Fractyl, Gila, Lilly, Nestle, Novo Nordisk, Scientific Intake, Structure Therapeutics, Wondr Health, and Zealand, payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Novo Nordisk and Lilly, participated on a data safety monitoring board or advisory board for Lilly, Rhythm, and Cin Rx, and holds stock options for Epitomee, Calibrate, Roman, Scientific Intake, and Xeno.