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This extended signaling allows for a steady, basal increase in growth hormone and IGF-1 levels without causing the aggressive spikes that disrupt natural endocrine rhythms

doi: 10.1053/j.gastro.2007.06.063 65 KnightsD.WardT

Receptor agonists are widely used in treating chronic diseases such as diabetes, asthma, neurological disorders, hormonal deficiencies, and cardiovascular conditions

The latter is particularly problematic as insulin resistance is strongly correlated with obesity

This does not mean the clinicians are unqualifiedbut it does mean that many online patients are not receiving care from those with formal expertise in obesity care