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There are two skeptics worth taking seriously, and both have a point

Investigators have also noted that the pronounced appetite-stimulating effect of MK-677 an on-target consequence of ghrelin receptor agonism in hypothalamic appetite circuits complicates body composition endpoints in metabolic studies, as caloric intake must be carefully controlled to isolate GH-axis-mediated changes from orexigenic-driven weight gain

NADPH is a major source of reducing power in cells, which can be used to regenerate glutathione and thioredoxin

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This leads to less bile release when food enters the small intestine

If you also need proven heart protection and you have type 2 diabetes with established cardiovascular disease, semaglutide (Ozempic) has an FDA indication for this benefit