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Factors specific to retatrutide that might affect real-world outcomes include: The higher side effect rate could drive more discontinuations The heart rate increase might concern prescribers and lead to lower maintenance doses If pricing is higher than tirzepatide, cost barriers could limit access and adherence The more complex triple-agonist mechanism may require more careful monitoring, adding burden Conversely, the additional metabolic benefits (liver fat reduction, possibly better muscle preservation) might improve adherence by providing visible results beyond scale weight, motivating continued use

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