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It usually reflects a lowered resting metabolic rate from having lost fat and some muscle mass and hormonal adaptations that increase appetite and reduce energy expenditure

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Ideally, quantification of secreted GLP-1 must be based on its concentration immediately at the site of its release in the intestine where it exerts a local effect to activate vagal sensory neurons within the intestinal wall so that vasovagal reflexes important to global metabolic homeostasis can be initiated 26,27

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