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This is because Ipamorelin has high selectivity for the GHSR-1a receptor on pituitary somatotrophs and does not significantly activate the adrenocortical axis or stimulate prolactin-releasing pathways
Both receptors canonical signaling pathway involves coupling to Gs proteins, and in turn, triggers adenylyl cyclase activation and leads to the production of cyclic adenosine monophosphate (cAMP)
Across all groups, proportions in each weight category stabilized after 12 months, with small variations between months 12 and 24, suggesting long-term weight trajectories are largely set by one-year post-cessation
These are plausible pathway-level mechanisms
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