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Molecules 26 (10), 2999

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The figure shows the precursors of L-methylmalonyl-CoA: Fatty acids and amino acids can be metabolized to propionyl-CoA, which is converted to D-methylmalonyl-CoA and then to L-methylmalonyl-CoA

doi: 10.2147/DDDT.S365416 21

"Many of these patients eventually resort to aesthetic medicine to address the consequences of rapid weight loss on the body, such as sagging upper arms, excess abdominal skin, fallen buttocks and laxity in the thighs - all resulting from fast weight loss combined with a lack of resistance training and a poor diet." Effects on various parts of the body can include: Sagging arms: When weight is shed rapidly, the subcutaneous fat on the inner arms is also reduced

The result is a larger, sustained, dual-pathway GH pulse versus a brief single-pathway pulse