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In obesity, elevated leptin levels promote Th1 and Th17 polarization, impair regulatory T-cell function, and enhance autoreactive immune responses, while hypoadiponectinemia removes a key anti-inflammatory brake [34,35]

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However, as multiple regulatory analysts have noted, the "affordability" rationale alone does not constitute clinical need under the FDA's current framework

Weight loss was dose-dependent, with adults receiving a higher dose of medication achieving a greater weight reduction

This conclusion is supported by the following observations: (1) Remission occurs in the immediate postoperative period before any weight loss occurs, (2) remission is more pronounced after RYGB surgery as compared with outcomes achieved by dieting in order to achieve comparable weight loss, and (3) remission is more pronounced after RYGB surgery as compared with other forms of bariatric surgery (sleeve gastrectomy and gastric banding)