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These taxa contribute to butyrate and propionate production, metabolites that have been implicated in modulating endogenous GLP-1 secretion, intestinal barrier integrity, and inflammatory tone

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Pushing past that plateau often requires: Maximum medication doses with worse side effects Caloric restriction below sustainable levels (under 1,200-1,400 calories/day for most adults) Exercise volume that interferes with work, family, or quality of life Psychological fixation on the scale that creates disordered eating patterns A thoughtful clinician might argue: if you've achieved metabolic health improvements and plateaued at a weight 15-20% below starting weight, the risk-benefit ratio of pushing further may not favor continued aggressive intervention