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Proposed mechanisms include phage modulation, activation of the BA-FXR-fibroblast growth factor 19 (FGF19) axis, restoration of gut barrier integrity, and enhanced production of beneficial microbial metabolites such as short-chain fatty acids (SCFAs) 180,181

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The exact mechanisms are still being studied, but GIP appears to enhance fat metabolism and improve insulin sensitivity in ways that complement the appetite-suppressing effects of GLP-1