GIP

selectively resects gastric mucosal parietal cells to reduce overall meal

volume capacity.

GIP

acts as a competitive antagonist at the GLP-1 receptor to prevent receptor

desensitization, allowing low-dose GLP-1 to bind indefinitely.

Qsymia

(Phentermine/Topiramate)

Direct activation of POMC neurons and indirect

inhibition of NPY/AgRP neurons via GABAergic interneurons.

Luminal competitive inhibition of gastric and

pancreatic lipases in the small intestine, resulting in fecal excretion of

30–35% of ingested fat.

Systemic

inhibition of hepatic fatty acid synthase, resulting in a 50% decrease in

circulating VLDL triglyceride incorporation.

Bypass

of the proximal jejunum eliminates postprandial insulin release, while

stimulating basal glucagon secretion from parietal cells

Resection

of the distal duodenum increases ghrelin secretion, while delayed gastric

emptying suppresses postprandial CCK and GIP release.