The IC50 value of truncated Ex4 is 0.6 nM compared to 1.0 nM for Ex4 and 1.6 nM for GLP-1 (Runge et al., 2008)
It is also about the loss of hormonal protection, especially estrogen

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Age matters
A conservative estimate suggests that a 50-pound weight regain costs $5,000 to $15,000 in direct healthcare costs over the following five years through increased medications, more frequent provider visits, and management of weight-related complications