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We propose a pathway divided into three sequential stages: Intensive phase (metabolic optimization): for those planning pregnancy within 612 months, GLP-1RAs can be used for 36 months of intensive weight loss (using a 5%10% reduction as an actionable threshold), while simultaneously improving background risks such as IR, MASLD, and lipid profiles

For cardiovascular protection Cardiovascular benefits appear most robustly at moderate to higher doses maintained consistently over time