As energy substrates, BCAAs can serve as alternative energy sources during glycogen depletion, with their oxidative products replenishing tricarboxylic acid cycle intermediates and maintaining energy homeostasis ( Figure 2 Precision in terminology is essential for interpreting BCAA research and avoiding conflation of mechanistically distinct entities
Notably, co-administration with farnesoid X receptor (FXR) agonists or peroxisome proliferator-activated receptor (PPAR) agonists may enhance lipid metabolism regulation and anti-inflammatory effects, addressing multiple pathogenic pathways simultaneously
In Phase 1, GLP-1s went mainstream
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Long-term treatment may continue for years with ongoing monitoring, though some patients may eventually discontinue with appropriate support for weight maintenance
