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Occupancy stays low, but each engaged receptor keeps sending its main message longer than it would under a balanced signal (cAMP bias with low receptor internalization). In a head-to-head trial against liraglutide, tirzepatide reduced measured food intake and craving more despite lower GLP-1 occupancy. The effect lowers the drive to eat rather than increasing restraint

doi: 10.4239/wjd.v12.i7.916 28 LattNDoreG

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Potential participants without a diagnosis of diabetes and with an MMSE score of 24 or greater will be asked to give full informed consent and to provide a blood sample and, if eligible, have their results and contact information passed to the OPEN study team