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However, their mechanisms of action are not fully understood and multiple signal pathways could be involved

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Some patients even develop atrophic gastritis which can amplify the inability to absorb the nutrients from their foods

This absence of IGF-1 stimulation is critical for appetite neutrality because IGF-1 has known effects on hypothalamic neuropeptide expression, including alterations to neuropeptide Y (NPY) and agouti-related peptide (AgRP), both potent appetite stimulators