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Slaidina M, Lehmann R

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Metabolic rate increase and thermogenesis How tesofensine boosts metabolism: Norepinephrine stimulates beta-adrenergic receptors Activates thermogenesis in brown and white fat Increases basal metabolic rate 5-10% Enhanced fat oxidation (preferential fat burning) Similar to ephedrine effects but stronger Energy expenditure studies: Clinical trials showed increased resting energy expenditure 24-hour metabolic rate elevated 5-10% Translates to ~100-200 extra calories burned daily Combined with appetite suppression = larger deficit Thermogenesis mechanism: Why metabolism boost matters: Creates deficit even without appetite changes Counteracts metabolic adaptation Preserves lean mass better Enhanced fat loss vs muscle loss Different advantage vs GLP-1 agonists Cardiovascular cost: Increased metabolism = increased heart rate Blood pressure elevation Cardiac workload increased Major safety concern Why FDA rejected despite efficacy See best peptides for energy and fat loss peptides

The DASH diet promotes vegetables, fruits, and whole grains, as well as limits full-fat dairy products, tropical oils, and fatty meats, which are more acidic

Patients with type 2 diabetes should work closely with their GP or diabetes specialist nurse to implement alternative glucose management strategies before stopping treatment