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Subject: Does Tesamorelin Have a Monopoly on Visceral Fat? Not So Fast.
From: Derek from Peptide Price <derekpruski@substack.com>
To: tjphuhs@gmail.com
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Date: Tue, 17 Mar 2026 18:53:19 +0000
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Sender: Derek from Peptide Price <derekpruski@substack.com>
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View this post on the web at https://derekpruski.substack.com/p/does-tesamo=
relin-have-a-monopoly

There=E2=80=99s a claim that gets repeated constantly in the peptide resear=
ch space:
=E2=80=9CTesamorelin is the only peptide proven to burn visceral fat.=E2=80=
=9D
And if you=E2=80=99ve spent any time researching GH secretagogues, you=E2=
=80=99ve probably accepted this as settled fact and moved on. I did for a w=
hile too.
But the more I dug into it, the more I realized we=E2=80=99ve been conflati=
ng two very different things: =E2=80=9Cthis compound has been studied for v=
isceral fat=E2=80=9D and =E2=80=9Cthis compound burns visceral fat.=E2=80=
=9D Those aren=E2=80=99t the same statement. Not even close.
So let=E2=80=99s actually pull this apart.
What Is Visceral Fat, and Why Does It Matter?
Before anything else, it helps to understand what we=E2=80=99re actually ta=
lking about.
Your body stores fat in two main places. Subcutaneous fat sits just under y=
our skin =E2=80=94 it=E2=80=99s the stuff you can grab with your fingers. V=
isceral fat is different. It sits deep inside your abdominal cavity, packed=
 around your organs =E2=80=94 your liver, intestines, kidneys. You can=E2=
=80=99t see it or pinch it. Someone can look relatively lean on the outside=
 and still be carrying a dangerous amount of visceral fat internally.
Why does it matter? Because visceral fat isn=E2=80=99t just stored energy s=
itting quietly. It=E2=80=99s metabolically active tissue that releases infl=
ammatory molecules, disrupts insulin signaling, raises cardiovascular risk,=
 and drives a whole cascade of metabolic dysfunction. High visceral fat is =
strongly associated with type 2 diabetes, heart disease, and all-cause mort=
ality. It=E2=80=99s not a cosmetic issue =E2=80=94 it=E2=80=99s a health is=
sue.
And here=E2=80=99s the part that=E2=80=99s directly relevant to this conver=
sation: visceral fat and growth hormone have an inverse relationship. When =
GH is high, visceral fat tends to be low. When GH is low or blunted =E2=80=
=94 which happens naturally as we age, and more severely in certain medical=
 conditions =E2=80=94 visceral fat tends to accumulate. They regulate each =
other in a feedback loop that, once it tips the wrong way, is genuinely har=
d to reverse through diet and exercise alone.
So Where Did Tesamorelin Come From?
Tesamorelin is a synthetic version of a molecule your body already makes ca=
lled Growth Hormone-Releasing Hormone, or GHRH. Your hypothalamus =E2=80=94=
 a small structure deep in your brain =E2=80=94 produces GHRH naturally to =
tell your pituitary gland to release growth hormone. Tesamorelin mimics tha=
t signal.
It was developed and studied specifically in HIV/AIDS patients who develope=
d a condition called lipodystrophy. When antiretroviral drugs became widely=
 used in the late 1990s and 2000s, doctors started noticing that patients o=
n these medications were accumulating large amounts of visceral fat around =
their organs while simultaneously losing fat from their face and limbs. It =
was disfiguring, uncomfortable, and metabolically dangerous.
Researchers noticed something else too: these patients had blunted GH secre=
tion. The feedback loop had tipped the wrong way. More visceral fat suppres=
sing GH, lower GH allowing even more visceral fat to accumulate. Tesamoreli=
n was used to try to restore that GH signaling and break the cycle.
The pivotal clinical trials =E2=80=94 published in the New England Journal =
of Medicine in 2010 by Falutz and colleagues =E2=80=94 showed roughly 15 to=
 18 percent reduction in visceral fat over 26 weeks. That=E2=80=99s a meani=
ngful, measurable, clinically significant result. The FDA approved it that =
same year under the trade name Egrifta.
The evidence is real. Nobody is disputing that.
But Here=E2=80=99s What the Story Leaves Out
The reason Tesamorelin got a $10 million clinical trial and most other pept=
ides didn=E2=80=99t has less to do with biology and more to do with pharmac=
eutical economics.
Running a proper visceral fat trial =E2=80=94 26 weeks, randomized, placebo=
-controlled, with MRI or CT imaging to accurately measure visceral fat at b=
aseline and endpoint =E2=80=94 is enormously expensive. You need to fund it=
, and you need a reason to fund it. That reason, in the pharmaceutical worl=
d, is a patent.
Tesamorelin was a novel, proprietary compound. Theratechnologies, the compa=
ny that developed it, had patent protection and a clear commercial pathway.=
 Investing in the trial made financial sense.
Sermorelin? No patent protection. CJC-1295? Same story. Ipamorelin? Nobody=
=E2=80=99s running a $10 million visceral fat trial on a compound they can=
=E2=80=99t exclusively profit from. That=E2=80=99s just the reality of how =
drug development works.
So when people say =E2=80=9CTesamorelin is the only peptide with evidence f=
or visceral fat reduction,=E2=80=9D what they=E2=80=99re really saying =E2=
=80=94 whether they realize it or not =E2=80=94 is =E2=80=9CTesamorelin is =
the only peptide that a pharmaceutical company had sufficient financial inc=
entive to study for visceral fat reduction.=E2=80=9D That=E2=80=99s a fundi=
ng gap. Not necessarily a biology gap.
How Growth Hormone Actually Burns Visceral Fat
This part matters because it applies to every GH secretagogue, not just Tes=
amorelin.
When growth hormone rises in your body, it activates an enzyme called hormo=
ne-sensitive lipase. That enzyme breaks down stored triglycerides =E2=80=94=
 the form fat is stored in =E2=80=94 into free fatty acids that your body c=
an actually use for energy. That process is called lipolysis, and it=E2=80=
=99s the fundamental mechanism through which GH drives fat loss.
Here=E2=80=99s the key detail: visceral fat has a higher density of GH rece=
ptors than subcutaneous fat. When GH goes up, your body preferentially mobi=
lizes visceral fat first. It=E2=80=99s more sensitive to GH-driven lipolysi=
s than the fat under your skin. This isn=E2=80=99t a Tesamorelin-specific p=
henomenon =E2=80=94 it=E2=80=99s just how GH receptor distribution works in=
 adipose tissue.
Growth hormone also stimulates your liver to produce IGF-1 =E2=80=94 Insuli=
n-like Growth Factor 1 =E2=80=94 which acts downstream to support muscle pr=
eservation while fat is being broken down. So the full cascade looks like t=
his: GH rises, visceral fat breaks down preferentially, IGF-1 rises, lean m=
ass is protected. Tesamorelin triggers this cascade. So do the other secret=
agogues.
The question isn=E2=80=99t whether this mechanism exists. It does, and it=
=E2=80=99s well documented. The question is how effectively each compound t=
riggers it, and for how long.
The Other Secretagogues: What We Actually Know
Let=E2=80=99s go through them one by one.
Sermorelin
Sermorelin is the oldest GH secretagogue in widespread research use. Like T=
esamorelin, it=E2=80=99s a GHRH analogue =E2=80=94 it works on the same rec=
eptor and through the same mechanism. The difference is half-life. Sermorel=
in is cleared from your body in about 10 to 12 minutes. It triggers a GH pu=
lse, and then it=E2=80=99s gone.
A 2001 study by Vittone and colleagues looked at sermorelin in healthy olde=
r adults =E2=80=94 a population with naturally declining GH =E2=80=94 over =
six months. Fat mass decreased. Lean mass increased. Visceral fat wasn=E2=
=80=99t the specific endpoint, so we don=E2=80=99t have precise imaging dat=
a. But the directional result is exactly what you=E2=80=99d expect given th=
e mechanism.
The honest limitation here is that 10 minutes may simply not be long enough=
 to drive consistent, meaningful visceral fat mobilization over time. You=
=E2=80=99re getting a pulse, not sustained signaling.
CJC-1295
CJC-1295 comes in two versions and they behave very differently, so it=E2=
=80=99s worth separating them.
CJC-1295 without DAC =E2=80=94 sometimes called Mod GRF 1-29 =E2=80=94 has =
a half-life of around 30 minutes, putting it in the same range as Tesamorel=
in. It produces a pulsatile GH response and is typically dosed multiple tim=
es per day.
CJC-1295 with DAC is a different animal. DAC stands for Drug Affinity Compl=
ex =E2=80=94 it=E2=80=99s a modification that allows the peptide to bind to=
 albumin, a protein that circulates in your blood, dramatically extending h=
ow long it stays active. Half-life stretches out to around 8 days. Instead =
of a pulse, you get sustained, elevated GH over the better part of two week=
s from a single injection.
A 2006 pharmacology study by Teichman and colleagues published in the Journ=
al of Clinical Endocrinology and Metabolism showed that CJC-1295 produced d=
ose-dependent, sustained increases in both GH and IGF-1 in healthy adults. =
Body composition wasn=E2=80=99t the primary focus =E2=80=94 researchers wer=
e studying how the compound behaved in the body. But the hormonal environme=
nt it created is essentially identical to what Tesamorelin creates. The stu=
dy just wasn=E2=80=99t designed to look at what happened to visceral fat.
Ipamorelin
Ipamorelin is a GHRP =E2=80=94 a Growth Hormone Releasing Peptide =E2=80=94=
 which means it works through a completely different receptor than the GHRH=
 analogues. It mimics ghrelin, a hormone that powerfully stimulates GH rele=
ase through its own separate pathway. When you combine a GHRH analogue with=
 a GHRP, you hit both pathways simultaneously and get significantly more GH=
 than either would produce alone =E2=80=94 which is why CJC-1295 plus Ipamo=
relin became such a common research stack.
Ipamorelin=E2=80=99s half-life is roughly 2 hours, and it=E2=80=99s notable=
 for being the most cortisol-sparing of the GHRPs. That distinction matters=
 for this conversation. Cortisol =E2=80=94 your primary stress hormone =E2=
=80=94 is one of the main drivers of visceral fat accumulation. Some GHRPs,=
 particularly GHRP-2 and GHRP-6 at higher doses, raise cortisol meaningfull=
y, which can actively work against visceral fat reduction. Ipamorelin large=
ly avoids this, which theoretically makes it a cleaner option.
Dedicated visceral fat data doesn=E2=80=99t exist for Ipamorelin in humans.=
 But the mechanism is there, the cortisol problem is largely absent, and th=
e GH response is real.
MK-677 (Ibutamoren)
MK-677 is the outlier of the group. It=E2=80=99s taken orally =E2=80=94 no =
injection required =E2=80=94 and has a half-life of around 24 hours, meanin=
g it keeps GH and IGF-1 elevated throughout the day rather than producing d=
iscrete pulses.
It actually has some of the better human data in this class. A 1998 study b=
y Murphy and colleagues in the Journal of Clinical Endocrinology and Metabo=
lism showed MK-677 restored GH and IGF-1 to youthful levels in elderly adul=
ts with improvements in body composition. A 2008 study by Svensson and coll=
eagues showed increased fat-free mass in GH-deficient adults. These aren=E2=
=80=99t visceral fat specific endpoints, but the direction is consistent.
The complication with MK-677 is that it=E2=80=99s a ghrelin mimetic =E2=80=
=94 and ghrelin is your hunger hormone. Most research subjects report a sig=
nificant increase in appetite on MK-677, which in practice can offset fat l=
oss outcomes. It=E2=80=99s also worth noting that chronic, around-the-clock=
 GH elevation =E2=80=94 as opposed to the pulsatile release your body expec=
ts =E2=80=94 may over time cause GH receptors to become less sensitive, pot=
entially blunting the response.
Hexarelin and GHRP-2
Most of the data here comes from animal studies. In rodent models, both com=
pounds have been associated with reductions in overall adiposity and improv=
ements in lipid metabolism. Hexarelin has also shown cardioprotective effec=
ts in animal models of GH deficiency that are worth noting separately. Huma=
n visceral fat data simply doesn=E2=80=99t exist for either compound =E2=80=
=94 again, not because the biology doesn=E2=80=99t support it, but because =
no one has funded the trial.
Why Tesamorelin Is Still Probably the Best Option for This Specific Goal
To be fair to the conventional wisdom: Tesamorelin isn=E2=80=99t just backe=
d by evidence because of luck or funding. There are legitimate biological r=
easons it performs well for visceral fat specifically.
The half-life sweet spot matters. At roughly 26 minutes, dosed daily, Tesam=
orelin produces consistent pulsatile GH release that mirrors your body=E2=
=80=99s natural rhythm. This appears to be important. Your body expects GH =
in pulses =E2=80=94 it=E2=80=99s how the system evolved. Sustained, flat GH=
 elevation can eventually trigger receptor downregulation, meaning your bod=
y becomes less responsive over time. Tesamorelin avoids this by working wit=
h your physiology rather than overriding it.
The cortisol issue is real. For the GHRPs, cortisol elevation at higher dos=
es is a genuine concern for anyone specifically targeting visceral fat. Cor=
tisol and visceral fat accumulation are closely linked =E2=80=94 elevated c=
ortisol drives fat deposition centrally, right where you=E2=80=99re trying =
to reduce it. Tesamorelin as a GHRH analogue doesn=E2=80=99t have this prob=
lem. Neither does Ipamorelin, which is why it stands out from the other GHR=
Ps.
And the studied population amplified the measurable effect. HIV lipodystrop=
hy patients had severely, abnormally elevated visceral fat. A 15 to 18 perc=
ent reduction is a large signal that=E2=80=99s easy to detect statistically=
=2E In a metabolically healthier resear=
ch subject, the starting visceral fat=20=
burden is lower, the change will be smaller, and you=E2=80=99d need a large=
r, longer, more expensive study to detect it reliably. This makes it harder=
 to prove efficacy for other compounds even if the effect is real =E2=80=94=
 it=E2=80=99s a statistical challenge, not a biological one.
The Honest Bottom Line
Tesamorelin has the clinical evidence. That=E2=80=99s not in question.
What is worth questioning is the leap from =E2=80=9CTesamorelin has been st=
udied for this=E2=80=9D to =E2=80=9Cnothing else works for this.=E2=80=9D T=
hat leap isn=E2=80=99t supported. The mechanism for visceral fat reduction =
=E2=80=94 GH restoration driving preferential lipolysis in visceral depots =
=E2=80=94 is shared across this entire class of compounds. The studies that=
 do exist for the others point in the same direction. The gap is in the res=
earch, not the biology.
We don=E2=80=99t know exactly how much visceral fat benefit Sermorelin, CJC=
-1295, Ipamorelin, or MK-677 provide because no one has designed a proper s=
tudy to find out. That=E2=80=99s a funding and incentive problem in pharmac=
eutical research. It doesn=E2=80=99t mean the answer is zero.
The most accurate thing you can say is: Tesamorelin is the best-evidenced o=
ption for visceral fat reduction, it has legitimate biological advantages a=
round half-life and cortisol profile, and the other secretagogues almost ce=
rtainly have meaningful overlap through the same mechanism =E2=80=94 we jus=
t can=E2=80=99t quantify it yet.
That=E2=80=99s a very different statement than =E2=80=9Cthe others don=E2=
=80=99t work.=E2=80=9D
What I=E2=80=99m Actually Curious About
This is the part I genuinely don=E2=80=99t have a clean answer to, and I th=
ink it=E2=80=99s worth sitting with.
If you=E2=80=99ve run a longer protocol with CJC-1295, Ipamorelin, or MK-67=
7 =E2=80=94 did you track body composition with any precision? DEXA scans, =
waist circumference, anything consistent? And if you=E2=80=99ve run Tesamor=
elin specifically targeting visceral fat =E2=80=94 did the fat loss pattern=
 feel different? Did it come off in a different place than other secretagog=
ue cycles you=E2=80=99ve run?
The human trials may not exist yet. But the people actually running these p=
rotocols are accumulating observations that matter. Not controlled data =E2=
=80=94 but directional signal worth paying attention to.
If you have experience here, I=E2=80=99d genuinely like to hear it.
As always =E2=80=94 research use only.

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    min-width: 110px;
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}
@media (max-width: 650px) {
  .typography .markup .twitter-embed,
  .typography.editor .markup .twitter-embed,
  .typography .markup .tweet,
  .typography.editor .markup .tweet {
    padding: 12px;
  }
}
@media (max-width: 650px) {
  .typography .markup .twitter-embed .tweet-text,
  .typography.editor .markup .twitter-embed .tweet-text,
  .typography .markup .tweet .tweet-text,
  .typography.editor .markup .tweet .tweet-text {
    font-size: 14px;
    line-height: 20px;
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}
@media (max-width: 650px) {
  .typography .markup .twitter-embed .tweet-photos-container.two,
  .typography.editor .markup .twitter-embed .tweet-photos-container.two,
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  .typography.editor .markup .tweet .tweet-photos-container.two,
  .typography .markup .twitter-embed .tweet-photos-container.three,
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  .typography .markup .tweet .tweet-photos-container.three,
  .typography.editor .markup .tweet .tweet-photos-container.three,
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  .typography .markup .tweet .tweet-photos-container.four,
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    height: 200px;
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}
@media (max-width: 650px) {
  .typography .markup .twitter-embed a.expanded-link .expanded-link-img,
  .typography.editor .markup .twitter-embed a.expanded-link .expanded-link-=
img,
  .typography .markup .tweet a.expanded-link .expanded-link-img,
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}
@media (max-width: 650px) {
  .typography .markup .twitter-embed a.expanded-link .expanded-link-descrip=
tion,
  .typography.editor .markup .twitter-embed a.expanded-link .expanded-link-=
description,
  .typography .markup .tweet a.expanded-link .expanded-link-description,
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ion {
    display: none;
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}
@media screen and (max-width: 650px) {
  .typography .markup .apple-podcast-container,
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    width: unset;
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}
@media (max-width: 420px) {
  .typography .markup .install-substack-app-embed img.install-substack-app-=
embed-img,
  .typography.editor .markup .install-substack-app-embed img.install-substa=
ck-app-embed-img {
    margin: 0 auto 16px auto;
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}
@media (max-width: 420px) {
  .typography .markup .install-substack-app-embed .install-substack-app-emb=
ed-text,
  .typography.editor .markup .install-substack-app-embed .install-substack-=
app-embed-text {
    margin: 0 0 12px 0;
    max-width: 100%;
    width: auto;
    text-align: center;
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}
@media (max-width: 420px) {
  .typography .markup .install-substack-app-embed .install-substack-app-emb=
ed-link,
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app-embed-link {
    display: flex;
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}
@media screen and (min-width: 481px) {
  .share-button-container {
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}
@media screen and (min-width: 481px) {
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    height: 38px;
    line-height: 38px;
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}
@media screen and (max-width: 480px) {
  .share-button-container .separator {
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}
@media screen and (max-width: 480px) {
  .share-button-container a.share.first img {
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}
@media screen and (min-width: 481px) {
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}
@media screen and (min-width: 541px) {
  .settings-add-pub-modal-wrapper .container .add-recommending-pub-modal-co=
ntainer {
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}
@media screen and (min-width: 541px) {
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}
@media screen and (max-width: 650px) {
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}
@media screen and (max-width: 768px) {
  .post {
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}
@media screen and (max-width: 650px) {
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}
@media screen and (max-width: 650px) {
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}
@media screen and (max-width: 650px) {
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}
@media screen and (max-width: 650px) {
  .post .post-footer.use-separators {
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}
@media screen and (max-width: 650px) {
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}
@media screen and (max-width: 650px) {
  .post-contributor-footer .post-contributor-bio-table {
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}
@media screen and (min-width: 768px) {
  .post-silhouette {
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}
@media screen and (max-width: 650px) {
  .post-silhouette .post-silhouette-title {
    margin-top: 10.44225025px;
    height: 120px;
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}
@media screen and (max-width: 650px) {
  .post-silhouette .post-silhouette-meta {
    width: 75%;
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}
@media screen and (max-width: 650px) {
  .post-silhouette .post-silhouette-meta.with-byline-image {
    margin: 20px 0;
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}
@media screen and (max-width: 650px) {
  .use-theme-bg .post-meta.alternative-meta .post-meta-item,
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}
@media screen and (max-width: 370px) {
  .use-theme-bg .post-meta.alternative-meta .post-meta-item,
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    font-size: 14px;
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}
@media screen and (max-width: 650px) {
  .use-theme-bg .post-meta.alternative-meta .post-meta-item.guest-author-pu=
blication,
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    display: none;
  }
}
@media screen and (max-width: 370px) {
  .post-meta .post-meta-item .post-meta-button {
    height: 36px !important;
    /* important to override in-line height style on emails */
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  .post-meta .post-meta-item .post-meta-button .meta-button-label {
    display: none;
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  .post-meta .post-meta-item .post-meta-button > svg {
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}
@media screen and (max-width: 370px) {
  .post-meta .post-meta-item {
    font-size: 12px;
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}
@media screen and (max-width: 650px) {
  .post .floating-subscribe-button {
    bottom: 20px;
    right: 20px;
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}
@media (max-width: 1024px) {
  body .pullquote-align-left,
  body .pullquote-align-right,
  body .pullquote-align-wide,
  body .pullquote-align-center {
    float: none;
    margin: 0 auto;
    width: 100%;
    max-width: 100%;
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}
@media all and (-ms-high-contrast: none), (-ms-high-contrast: active) {
  body .markup table.image-wrapper img,
  body .markup table.kindle-wrapper img {
    max-width: 550px;
  }
}
@media (min-width: 1024px) {
  body:not(:has(#toc)) .captioned-image-container figure:has(> a.image2-off=
set-left) {
    margin-left: var(--image-offset-margin);
  }
  body:not(:has(#toc)) .captioned-image-container figure:has(> a.image2-off=
set-right) {
    margin-right: var(--image-offset-margin);
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}
@media (min-width: 1300px) {
  body .captioned-image-container figure:has(> a.image2-offset-left) {
    margin-left: var(--image-offset-margin);
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  body .captioned-image-container figure:has(> a.image2-offset-right) {
    margin-right: var(--image-offset-margin);
  }
}
@media (max-width: 1024px) {
  body {
    /* Disable offset on mobile/tablet */
  }
  body .captioned-image-container figure:has(> a.image2-align-left),
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    float: none;
    margin: 1em auto;
    max-width: 100%;
    width: auto;
    padding: 0;
  }
  body .captioned-image-container figure:has(> a.image2-align-left.thefp),
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{
    margin: 1em auto;
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  body .captioned-image-container figure:has(> a.image2-offset-left),
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    margin: 1em auto;
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  body .captioned-image-container figure:has(> a.image2-align-left) .image2=
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2-inset {
    display: block;
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}
@media (max-width: 768px) {
  body .markup div.sponsorship-campaign-embed {
    margin-top: 24px;
    margin-bottom: 24px;
  }
  body .markup div.sponsorship-campaign-embed:first-child {
    margin-top: 0px;
  }
}
@media screen and (max-width: 650px) {
  body .markup div.youtube-overlay,
  body .markup div.vimeo-overlay {
    display: none !important;
  }
}
@media screen and (max-width: 370px) {
  body .markup div.tiktok-wrap {
    width: calc(95vw - 32px);
    height: calc((95vw - 32px - 2px) / 0.485714);
  }
}
@media screen and (max-width: 650px) {
  body .markup div.embedded-publication-wrap .embedded-publication.show-sub=
scribe {
    padding: 24px;
  }
}
@media screen and (max-width: 650px) {
  body .markup div.subscription-widget-wrap .subscription-widget.show-subsc=
ribe,
  body .markup div.subscription-widget-wrap-editor .subscription-widget.sho=
w-subscribe,
  body .markup div.captioned-button-wrap .subscription-widget.show-subscrib=
e {
    padding: 0px 24px;
  }
}
@media screen and (max-width: 650px) {
  body .markup div.subscription-widget-wrap .subscription-widget.show-subsc=
ribe .subscription-widget-subscribe .button,
  body .markup div.subscription-widget-wrap-editor .subscription-widget.sho=
w-subscribe .subscription-widget-subscribe .button,
  body .markup div.captioned-button-wrap .subscription-widget.show-subscrib=
e .subscription-widget-subscribe .button {
    padding: 10px 12px;
    min-width: 110px;
  }
}
@media (max-width: 650px) {
  body .markup .twitter-embed,
  body .markup .tweet {
    padding: 12px;
  }
}
@media (max-width: 650px) {
  body .markup .twitter-embed .tweet-text,
  body .markup .tweet .tweet-text {
    font-size: 14px;
    line-height: 20px;
  }
}
@media (max-width: 650px) {
  body .markup .twitter-embed .tweet-photos-container.two,
  body .markup .tweet .tweet-photos-container.two,
  body .markup .twitter-embed .tweet-photos-container.three,
  body .markup .tweet .tweet-photos-container.three,
  body .markup .twitter-embed .tweet-photos-container.four,
  body .markup .tweet .tweet-photos-container.four {
    height: 200px;
  }
}
@media (max-width: 650px) {
  body .markup .twitter-embed a.expanded-link .expanded-link-img,
  body .markup .tweet a.expanded-link .expanded-link-img {
    max-height: 180px;
  }
}
@media (max-width: 650px) {
  body .markup .twitter-embed a.expanded-link .expanded-link-description,
  body .markup .tweet a.expanded-link .expanded-link-description {
    display: none;
  }
}
@media screen and (max-width: 650px) {
  body .markup .apple-podcast-container {
    width: unset;
  }
}
@media (max-width: 420px) {
  body .markup .install-substack-app-embed img.install-substack-app-embed-i=
mg {
    margin: 0 auto 16px auto;
  }
}
@media (max-width: 420px) {
  body .markup .install-substack-app-embed .install-substack-app-embed-text=
 {
    margin: 0 0 12px 0;
    max-width: 100%;
    width: auto;
    text-align: center;
  }
}
@media (max-width: 420px) {
  body .markup .install-substack-app-embed .install-substack-app-embed-link=
 {
    display: flex;
    justify-content: center;
  }
}
@media screen and (min-width: 500px) {
  body .header a.logo {
    width: 42px;
    height: 42px;
    border-radius: 12px;
  }
}
@media screen and (max-width: 420px) {
  body .subscription-receipt table:first-of-type .subscription-amount .subs=
cription-discount {
    width: 72px !important;
  }
}
@media screen and (min-width: 481px) {
  body .share-button-container {
    height: auto;
  }
}
@media screen and (max-width: 480px) {
  body .share-button-container .separator {
    display: block !important;
    margin: 0 !important;
    height: 8px !important;
    border-left: none !important;
  }
}
@media screen and (max-width: 650px) {
  .digest .item .post-meta-item.audience {
    display: none;
  }
}
@media screen and (min-width: 500px) {
  .digest-publication .logo img {
    width: 42px;
    height: 42px;
    border-radius: 8px;
  }
}
@media screen and (max-width: 650px) {
  .comments-page .container .comment-list .collapsed-reply {
    margin-left: calc(10 + 32px - 24px);
  }
}
@media screen and (max-width: 650px) {
  .comment > .comment-list {
    padding-left: 24px;
  }
}
@media screen and (max-width: 650px) {
  .finish-magic-login-modal .modal-content .container {
    padding: 24px 0;
  }
}
@media (max-width: 650px) {
  .reader2-text-b3 {
    line-height: 24px;
  }
}
@media screen and (max-width: 650px) {
  .reader2-text-h4 {
    line-height: 24px;
  }
}
@media screen and (min-width: 541px) {
  .user-profile-modal {
    padding-left: 12px;
    padding-right: 12px;
  }
}
@media screen and (max-width: 650px) {
  .subscribe-widget form.form .sideBySideWrap button.rightButton {
    padding: 10px 12px;
  }
}
@media screen and (min-width: 541px) {
  .pub-icon:hover .logo-hover,
  .feed-item-icon:hover .logo-hover {
    display: block;
  }
}
@media screen and (max-width: 650px) {
  .post-ufi.single-full-width-button .post-ufi-button-wrapper {
    width: 100%;
    padding: 16px;
  }
  .post-ufi.single-full-width-button .post-ufi-button-wrapper:empty {
    display: none;
  }
  .post-ufi.single-full-width-button .post-ufi-button {
    width: 100%;
    justify-content: center;
  }
}
@media screen and (max-width: 768px) {
  .file-embed-wrapper {
    padding: 0;
  }
}
@media screen and (max-width: 768px) {
  .file-embed-wrapper-editor {
    padding: 0;
  }
}
@media screen and (max-width: 768px) {
  .file-embed-wrapper-editor:active {
    padding: 0;
  }
}
@media only screen and (max-width: 650px) {
  .file-embed-button.wide,
  .file-embed-error-button.wide {
    display: none;
  }
}
@media only screen and (min-width: 630px) {
  .file-embed-button.narrow,
  .file-embed-error-button.narrow {
    display: none;
  }
}
@media screen and (min-width: 541px) {
  .audio-player-wrapper .audio-player {
    min-width: 500px;
  }
}
@media screen and (max-width: 650px) {
  .audio-player-wrapper .audio-player .audio-player-progress {
    border-left-width: 16px;
    border-right-width: 16px;
  }
}
@media screen and (max-width: 650px) {
  .audio-player-wrapper .audio-player .audio-player-progress .audio-player-=
progress-bar .audio-player-progress-bar-popup {
    top: -54px;
  }
}
@media screen and (max-width: 650px) {
  .audio-player-wrapper-fancy .audio-player .audio-player-progress {
    border-left-width: 16px;
    border-right-width: 16px;
  }
}
@media screen and (max-width: 650px) {
  .audio-player-wrapper-fancy .audio-player .audio-player-progress .audio-p=
layer-progress-bar .audio-player-progress-bar-popup {
    top: -54px;
  }
}
@media (min-width: 250px) {
  .audio-player-wrapper-fancy .audio-player {
    padding: 32px;
  }
  .audio-player-wrapper-fancy .audio-player .btn-group {
    display: flex;
  }
  .audio-player-wrapper-fancy .audio-player .btn-group .button:last-of-type=
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    display: block;
  }
}
@media (min-width: 300px) {
  .audio-player-wrapper-fancy .audio-player .btn-group {
    display: block;
  }
  .audio-player-wrapper-fancy .audio-player .btn-group .button:first-of-typ=
e {
    display: block;
  }
}
@media (min-width: 350px) {
  .audio-player-wrapper-fancy .audio-player .audio-player-substack-logo {
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  .audio-player-wrapper-fancy .audio-player .audio-player-title {
    margin-top: 16px;
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  .audio-player-wrapper-fancy .audio-player .audio-player-hero-image-contai=
ner {
    padding-top: 15%;
    width: 15%;
    display: block;
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  .audio-player-wrapper-fancy .audio-player .btn-group .button:first-of-typ=
e {
    display: block;
  }
  .audio-player-wrapper-fancy .audio-player .audio-player-substack-logo {
    display: block;
  }
}
@media (min-width: 350px) {
  .audio-player-wrapper-fancy .audio-player .audio-player-hero-image-contai=
ner {
    padding-top: 25%;
    width: 25%;
    display: block;
  }
  .audio-player-wrapper-fancy .audio-player .btn-group {
    display: flex;
  }
  .audio-player-wrapper-fancy .audio-player .btn-group .button:first-of-typ=
e {
    display: block;
  }
}
@media (min-width: 400px) {
  .audio-player-wrapper-fancy .audio-player .audio-player-hero-image-contai=
ner {
    padding-top: 40%;
    width: 40%;
  }
}
@media (max-width: 400px) {
  .audio-player-wrapper-fancy .audio-player .btn-group {
    margin-top: 12px;
  }
  .audio-player-wrapper-fancy .audio-player .btn-group .button {
    font-size: 13px;
    padding: 6px 12px;
    height: auto;
    margin-top: 10px;
  }
}
@media (min-width: 600px) {
  .audio-player-wrapper-fancy .audio-player .audio-player-hero-image-contai=
ner {
    padding-top: 55%;
    width: 55%;
  }
}
@media (max-width: 650px) {
  .poll-editor-modal {
    min-width: calc(100% - 20px);
  }
}
@media (max-width: 750px) {
  .poll-embed .poll-anchor-target .poll-anchor-copy-button {
    left: 8px;
    top: 45px;
  }
}
@media not all and (min-resolution: 0.001dpcm) {
  @supports (-webkit-appearance: none) {
    p a:not(.primary.button),
    .post p:not(.button-wrapper) a:not(.primary.button),
    .footnote a.footnote-anchor:not(.primary.button),
    .thread-head .markup p:not(.button-wrapper) a:not(.primary.button) {
      color: #ff6719;
      text-decoration: none;
    }
    p a:not(.primary.button):hover,
    .post p:not(.button-wrapper) a:not(.primary.button):hover,
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    .thread-head .markup p:not(.button-wrapper) a:not(.primary.button):hove=
r {
      text-decoration: underline;
    }
  }
}</style></head><body class=3D"email-body" style=3D"font-kerning: auto;--im=
age-offset-margin: -120px;"><img src=3D"https://eotrx.substackcdn.com/open?=
token=3DeyJtIjoiPDIwMjYwMzE3MTg1MzE5LjMuYjMwMDcxYjI4YjllMDhmOEBtZzIuc3Vic3R=
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5zdWJzdGFjay5jb20iLCJwIjoxOTEyODcxMjUsInQiOiJuZXdzbGV0dGVyIiwiYSI6ImV2ZXJ5b=
25lIiwicyI6MzM2NTM2NywiYyI6InBvc3QiLCJmIjp0cnVlLCJwb3NpdGlvbiI6InRvcCIsImlh=
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=2EUyyES3qDIyMRYyBqsqO2hVHdIfUVL34XY=
txXvqRZqHA" alt=3D"" width=3D"1" height=
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e class=3D"email-body-container" role=3D"presentation" width=3D"100%" borde=
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tent" width=3D"550" align=3D"left"><div style=3D"font-size: 16px;line-heigh=
t: 26px;max-width: 550px;width: 100%;margin: 0 auto;overflow-wrap: break-wo=
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x;"><table role=3D"presentation" width=3D"auto" border=3D"0" cellspacing=3D=
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ubstack-secondary" style=3D"font-family: SF Pro Text, -apple-system, system=
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rif, Apple Color Emoji, Segoe UI Emoji, Segoe UI Symbol;font-size: 13px;col=
or: unset;list-style: none;text-decoration: unset;margin: 0;"><div class=3D=
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i','Segoe UI Emoji','Segoe UI Symbol';font-weight: bold;-webkit-font-smooth=
ing: antialiased;-moz-osx-font-smoothing: antialiased;-webkit-appearance: o=
ptimizelegibility;-moz-appearance: optimizelegibility;appearance: optimizel=
egibility;margin: 0;line-height: 36px;font-size: 32px;"><a href=3D"https://=
substack.com/app-link/post?publication_id=3D3365367&post_id=3D191287125&utm=
_source=3Dpost-email-title&utm_campaign=3Demail-post-title&isFreemail=3Dtru=
e&r=3D4iwoe6&token=3DeyJ1c2VyX2lkIjoyNzM2MjIzOTgsInBvc3RfaWQiOjE5MTI4NzEyNS=
wiaWF0IjoxNzczNzczNjA2LCJleHAiOjE3NzYzNjU2MDYsImlzcyI6InB1Yi0zMzY1MzY3Iiwic=
3ViIjoicG9zdC1yZWFjdGlvbiJ9.kR89aR2Cj6KU29oYxyrC4X-XCQYzuPZbyD2mo_SMnQI" st=
yle=3D"color: rgb(54,55,55);text-decoration: none;">Does Tesamorelin Have a=
 Monopoly on Visceral Fat? Not So Fast.</a></h1><table class=3D"post-meta" =
role=3D"presentation" width=3D"100%" border=3D"0" cellspacing=3D"0" cellpad=
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ng=3D"0" cellpadding=3D"0"><tbody><tr><td><table role=3D"presentation" widt=
h=3D"auto" border=3D"0" cellspacing=3D"0" cellpadding=3D"0"><tbody><tr><td =
style=3D"vertical-align:middle;"><div class=3D"pencraft pc-reset color-prim=
ary-zABazT line-height-20-t4M0El font-meta-MWBumP size-11-NuY2Zx weight-med=
ium-fw81nC transform-uppercase-yKDgcq reset-IxiVJZ meta-EgzBVA custom-css-e=
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ompact',-apple-system,system-ui,-apple-system,BlinkMacSystemFont,'Segoe UI'=
,Roboto,Helvetica,Arial,sans-serif,'Apple Color Emoji','Segoe UI Emoji','Se=
goe UI Symbol';font-weight: 500;text-transform: uppercase;letter-spacing: .=
2px;"><a class=3D"pencraft pc-reset color-primary-zABazT line-height-20-t4M=
0El font-meta-MWBumP size-11-NuY2Zx weight-medium-fw81nC transform-uppercas=
e-yKDgcq reset-IxiVJZ meta-EgzBVA" style=3D"list-style: none;color: rgb(54,=
55,55);margin: 0;font-size: 11px;line-height: 20px;font-family: 'SF Compact=
',-apple-system,system-ui,-apple-system,BlinkMacSystemFont,'Segoe UI',Robot=
o,Helvetica,Arial,sans-serif,'Apple Color Emoji','Segoe UI Emoji','Segoe UI=
 Symbol';font-weight: 500;text-transform: uppercase;letter-spacing: .2px;te=
xt-decoration: none" href=3D"https://substack.com/@peptideprice">Derek</a><=
/div></td></tr></tbody></table></td></tr><tr><td><table role=3D"presentatio=
n" width=3D"auto" border=3D"0" cellspacing=3D"0" cellpadding=3D"0"><tbody><=
tr><td style=3D"vertical-align:middle;"><div class=3D"pencraft pc-reset col=
or-secondary-ls1g8s line-height-20-t4M0El font-meta-MWBumP size-11-NuY2Zx w=
eight-medium-fw81nC transform-uppercase-yKDgcq reset-IxiVJZ meta-EgzBVA" st=
yle=3D"list-style: none;font-size: 11px;line-height: 20px;text-decoration: =
unset;color: rgb(119,119,119);margin: 0;font-family: 'SF Compact',-apple-sy=
stem,system-ui,-apple-system,BlinkMacSystemFont,'Segoe UI',Roboto,Helvetica=
,Arial,sans-serif,'Apple Color Emoji','Segoe UI Emoji','Segoe UI Symbol';fo=
nt-weight: 500;text-transform: uppercase;letter-spacing: .2px;"><time datet=
ime=3D"2026-03-17T18:53:19.707Z">Mar 17</time></div></td></tr></tbody></tab=
le></td></tr></tbody></table></td><td align=3D"right"><table role=3D"presen=
tation" width=3D"auto" border=3D"0" cellspacing=3D"0" cellpadding=3D"0"><tb=
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h: 40px;height: 40px;min-width: 40px;min-height: 40px;object-fit: cover;mar=
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ottom: 1px solid rgb(0,0,0,.1);min-width: 100%;"><tbody><tr height=3D"16"><=
td height=3D"16" style=3D"font-size:0px;line-height:0;">&nbsp;</td></tr><tr=
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0" cellpadding=3D"0"><tbody><tr><td align=3D"center"><a class=3D"email-butt=
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;border: 1px solid rgb(0,0,0,.1);border-radius: 9999px;text-transform: uppe=
rcase;font-size: 12px;line-height: 12px;padding: 9px 14px;text-decoration: =
none;color: rgb(119,119,119);"><div class=3D"email-button-spacer" style=3D"=
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class=3D"icon text-icon" src=3D"https://substackcdn.com/image/fetch/$s_!ET-=
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ck.com%2Ficon%2FLucideArrowUpRight%3Fv%3D4%26height%3D36%26fill%3Dnone%26st=
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able></td></tr></tbody></table></td></tr></tbody></table></td></tr><tr heig=
ht=3D"16"><td height=3D"16" style=3D"font-size:0px;line-height:0;">&nbsp;</=
td></tr></tbody></table></div></div><div class=3D"post typography" dir=3D"a=
uto" style=3D"--image-offset-margin: -120px;padding: 32px 0 0 0;font-size: =
16px;line-height: 26px;"><div class=3D"body markup" dir=3D"auto" style=3D"t=
ext-align: initial;font-size: 16px;line-height: 26px;width: 100%;word-break=
: break-word;margin-bottom: 16px;"><p style=3D"margin: 0 0 20px 0;color: rg=
b(54,55,55);line-height: 26px;font-size: 16px;margin-top: 0;">There&#8217;s=
 a claim that gets repeated constantly in the peptide research space:</p><p=
 style=3D"margin: 0 0 20px 0;color: rgb(54,55,55);line-height: 26px;font-si=
ze: 16px;"><em>&#8220;Tesamorelin is the only peptide proven to burn viscer=
al fat.&#8221;</em></p><p style=3D"margin: 0 0 20px 0;color: rgb(54,55,55);=
line-height: 26px;font-size: 16px;">And if you&#8217;ve spent any time rese=
arching GH secretagogues, you&#8217;ve probably accepted this as settled fa=
ct and moved on. I did for a while too.</p><p style=3D"margin: 0 0 20px 0;c=
olor: rgb(54,55,55);line-height: 26px;font-size: 16px;"><span>But the more =
I dug into it, the more I realized we&#8217;ve been conflating two very dif=
ferent things: </span><strong>&#8220;this compound has been studied for vis=
ceral fat&#8221;</strong><span> and </span><strong>&#8220;this compound bur=
ns visceral fat.&#8221;</strong><span> Those aren&#8217;t the same statemen=
t. Not even close.</span></p><p style=3D"margin: 0 0 20px 0;color: rgb(54,5=
5,55);line-height: 26px;font-size: 16px;">So let&#8217;s actually pull this=
 apart.</p><div class=3D"captioned-image-container-static" style=3D"font-si=
ze: 16px;line-height: 26px;margin: 32px auto;"><figure style=3D"width: 100%=
;margin: 0 auto;"><table class=3D"image-wrapper" width=3D"100%" border=3D"0=
" cellspacing=3D"0" cellpadding=3D"0" data-component-name=3D"Image2ToDOMSta=
tic" style=3D"mso-padding-alt: 1em 0 1.6em;"><tbody><tr><td style=3D"text-a=
lign: center;"></td><td class=3D"content" align=3D"left" width=3D"370" styl=
e=3D"text-align: center;"><a class=3D"image-link" target=3D"_blank" href=3D=
"https://substack.com/redirect/cad2e299-1936-4ed6-9f4b-b23b289e861c?j=3DeyJ=
1IjoiNGl3b2U2In0.sVDxRtmZ85v8kfdamY0krRXGMy3p768BWtuZifRB-Zs" rel=3D"" styl=
e=3D"position: relative;flex-direction: column;align-items: center;padding:=
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ck;margin: 0;"><img data-attrs=3D"{&quot;src&quot;:&quot;https://substack-p=
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al-align: middle;display: block;-ms-interpolation-mode: bicubic;height: aut=
o;margin-bottom: 0;width: auto !important;max-width: 100% !important;margin=
: 0 auto;"></a></td><td style=3D"text-align: center;"></td></tr></tbody></t=
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RlcmVrcHJ1c2tpLnN1YnN0YWNrLmNvbSUyRnAlMkZkb2VzLXRlc2Ftb3JlbGluLWhhdmUtYS1tb=
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cHViLTAiLCJzdWIiOiJsaW5rLXJlZGlyZWN0In0.mS6pa-hnHXDVy5n2bk5_DYaDwawxokXYklb=
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1287125" style=3D"font-family: system-ui,-apple-system,BlinkMacSystemFont,'=
Segoe UI',Roboto,Helvetica,Arial,sans-serif,'Apple Color Emoji','Segoe UI E=
moji','Segoe UI Symbol';display: inline-block;box-sizing: border-box;cursor=
: pointer;border: none;border-radius: 8px;font-size: 14px;line-height: 20px=
;font-weight: 600;text-align: center;opacity: 1;outline: none;white-space: =
nowrap;text-decoration: none !important;margin: 0 auto;background-color: #F=
F6719;color: #ffffff !important;padding: 12px 20px;height: auto;"><span sty=
le=3D"color: #ffffff;text-decoration: none;">Upgrade to paid</span></a></di=
v></div><p style=3D"margin: 0 0 20px 0;color: rgb(54,55,55);line-height: 26=
px;font-size: 16px;"></p><p style=3D"margin: 0 0 20px 0;color: rgb(54,55,55=
);line-height: 26px;font-size: 16px;"><strong>What Is Visceral Fat, and Why=
 Does It Matter?</strong></p><p style=3D"margin: 0 0 20px 0;color: rgb(54,5=
5,55);line-height: 26px;font-size: 16px;">Before anything else, it helps to=
 understand what we&#8217;re actually talking about.</p><p style=3D"margin:=
 0 0 20px 0;color: rgb(54,55,55);line-height: 26px;font-size: 16px;">Your b=
ody stores fat in two main places. Subcutaneous fat sits just under your sk=
in &#8212; it&#8217;s the stuff you can grab with your fingers. Visceral fa=
t is different. It sits deep inside your abdominal cavity, packed around yo=
ur organs &#8212; your liver, intestines, kidneys. You can&#8217;t see it o=
r pinch it. Someone can look relatively lean on the outside and still be ca=
rrying a dangerous amount of visceral fat internally.</p><p style=3D"margin=
: 0 0 20px 0;color: rgb(54,55,55);line-height: 26px;font-size: 16px;">Why d=
oes it matter? Because visceral fat isn&#8217;t just stored energy sitting =
quietly. It&#8217;s metabolically active tissue that releases inflammatory =
molecules, disrupts insulin signaling, raises cardiovascular risk, and driv=
es a whole cascade of metabolic dysfunction. High visceral fat is strongly =
associated with type 2 diabetes, heart disease, and all-cause mortality. It=
&#8217;s not a cosmetic issue &#8212; it&#8217;s a health issue.</p><p styl=
e=3D"margin: 0 0 20px 0;color: rgb(54,55,55);line-height: 26px;font-size: 1=
6px;">And here&#8217;s the part that&#8217;s directly relevant to this conv=
ersation: visceral fat and growth hormone have an inverse relationship. Whe=
n GH is high, visceral fat tends to be low. When GH is low or blunted &#821=
2; which happens naturally as we age, and more severely in certain medical =
conditions &#8212; visceral fat tends to accumulate. They regulate each oth=
er in a feedback loop that, once it tips the wrong way, is genuinely hard t=
o reverse through diet and exercise alone.</p><div style=3D"font-size: 16px=
;line-height: 26px;"><hr style=3D"margin: 32px 0;padding: 0;height: 1px;bac=
kground: rgb(0,0,0,.1);border: none;"></div><p style=3D"margin: 0 0 20px 0;=
color: rgb(54,55,55);line-height: 26px;font-size: 16px;"><strong>So Where D=
id Tesamorelin Come From?</strong></p><p style=3D"margin: 0 0 20px 0;color:=
 rgb(54,55,55);line-height: 26px;font-size: 16px;">Tesamorelin is a synthet=
ic version of a molecule your body already makes called Growth Hormone-Rele=
asing Hormone, or GHRH. Your hypothalamus &#8212; a small structure deep in=
 your brain &#8212; produces GHRH naturally to tell your pituitary gland to=
 release growth hormone. Tesamorelin mimics that signal.</p><p style=3D"mar=
gin: 0 0 20px 0;color: rgb(54,55,55);line-height: 26px;font-size: 16px;">It=
 was developed and studied specifically in HIV/AIDS patients who developed =
a condition called lipodystrophy. When antiretroviral drugs became widely u=
sed in the late 1990s and 2000s, doctors started noticing that patients on =
these medications were accumulating large amounts of visceral fat around th=
eir organs while simultaneously losing fat from their face and limbs. It wa=
s disfiguring, uncomfortable, and metabolically dangerous.</p><p style=3D"m=
argin: 0 0 20px 0;color: rgb(54,55,55);line-height: 26px;font-size: 16px;">=
Researchers noticed something else too: these patients had blunted GH secre=
tion. The feedback loop had tipped the wrong way. More visceral fat suppres=
sing GH, lower GH allowing even more visceral fat to accumulate. Tesamoreli=
n was used to try to restore that GH signaling and break the cycle.</p><p s=
tyle=3D"margin: 0 0 20px 0;color: rgb(54,55,55);line-height: 26px;font-size=
: 16px;">The pivotal clinical trials &#8212; published in the New England J=
ournal of Medicine in 2010 by Falutz and colleagues &#8212; showed roughly =
15 to 18 percent reduction in visceral fat over 26 weeks. That&#8217;s a me=
aningful, measurable, clinically significant result. The FDA approved it th=
at same year under the trade name Egrifta.</p><p style=3D"margin: 0 0 20px =
0;color: rgb(54,55,55);line-height: 26px;font-size: 16px;">The evidence is =
real. Nobody is disputing that.</p><div style=3D"font-size: 16px;line-heigh=
t: 26px;"><hr style=3D"margin: 32px 0;padding: 0;height: 1px;background: rg=
b(0,0,0,.1);border: none;"></div><p style=3D"margin: 0 0 20px 0;color: rgb(=
54,55,55);line-height: 26px;font-size: 16px;"><strong>But Here&#8217;s What=
 the Story Leaves Out</strong></p><p style=3D"margin: 0 0 20px 0;color: rgb=
(54,55,55);line-height: 26px;font-size: 16px;">The reason Tesamorelin got a=
 $10 million clinical trial and most other peptides didn&#8217;t has less t=
o do with biology and more to do with pharmaceutical economics.</p><p style=
=3D"margin: 0 0 20px 0;color: rgb(54,55,55);line-height: 26px;font-size: 16=
px;">Running a proper visceral fat trial &#8212; 26 weeks, randomized, plac=
ebo-controlled, with MRI or CT imaging to accurately measure visceral fat a=
t baseline and endpoint &#8212; is enormously expensive. You need to fund i=
t, and you need a reason to fund it. That reason, in the pharmaceutical wor=
ld, is a patent.</p><p style=3D"margin: 0 0 20px 0;color: rgb(54,55,55);lin=
e-height: 26px;font-size: 16px;">Tesamorelin was a novel, proprietary compo=
und. Theratechnologies, the company that developed it, had patent protectio=
n and a clear commercial pathway. Investing in the trial made financial sen=
se.</p><p style=3D"margin: 0 0 20px 0;color: rgb(54,55,55);line-height: 26p=
x;font-size: 16px;">Sermorelin? No patent protection. CJC-1295? Same story.=
 Ipamorelin? Nobody&#8217;s running a $10 million visceral fat trial on a c=
ompound they can&#8217;t exclusively profit from. That&#8217;s just the rea=
lity of how drug development works.</p><p style=3D"margin: 0 0 20px 0;color=
: rgb(54,55,55);line-height: 26px;font-size: 16px;">So when people say &#82=
20;Tesamorelin is the only peptide with evidence for visceral fat reduction=
,&#8221; what they&#8217;re really saying &#8212; whether they realize it o=
r not &#8212; is &#8220;Tesamorelin is the only peptide that a pharmaceutic=
al company had sufficient financial incentive to study for visceral fat red=
uction.&#8221; That&#8217;s a funding gap. Not necessarily a biology gap.</=
p><div style=3D"font-size: 16px;line-height: 26px;"><hr style=3D"margin: 32=
px 0;padding: 0;height: 1px;background: rgb(0,0,0,.1);border: none;"></div>=
<p style=3D"margin: 0 0 20px 0;color: rgb(54,55,55);line-height: 26px;font-=
size: 16px;"><strong>How Growth Hormone Actually Burns Visceral Fat</strong=
></p><p style=3D"margin: 0 0 20px 0;color: rgb(54,55,55);line-height: 26px;=
font-size: 16px;">This part matters because it applies to every GH secretag=
ogue, not just Tesamorelin.</p><p style=3D"margin: 0 0 20px 0;color: rgb(54=
,55,55);line-height: 26px;font-size: 16px;">When growth hormone rises in yo=
ur body, it activates an enzyme called hormone-sensitive lipase. That enzym=
e breaks down stored triglycerides &#8212; the form fat is stored in &#8212=
; into free fatty acids that your body can actually use for energy. That pr=
ocess is called lipolysis, and it&#8217;s the fundamental mechanism through=
 which GH drives fat loss.</p><p style=3D"margin: 0 0 20px 0;color: rgb(54,=
55,55);line-height: 26px;font-size: 16px;">Here&#8217;s the key detail: vis=
ceral fat has a higher density of GH receptors than subcutaneous fat. When =
GH goes up, your body preferentially mobilizes visceral fat first. It&#8217=
;s more sensitive to GH-driven lipolysis than the fat under your skin. This=
 isn&#8217;t a Tesamorelin-specific phenomenon &#8212; it&#8217;s just how =
GH receptor distribution works in adipose tissue.</p><p style=3D"margin: 0 =
0 20px 0;color: rgb(54,55,55);line-height: 26px;font-size: 16px;">Growth ho=
rmone also stimulates your liver to produce IGF-1 &#8212; Insulin-like Grow=
th Factor 1 &#8212; which acts downstream to support muscle preservation wh=
ile fat is being broken down. So the full cascade looks like this: GH rises=
, visceral fat breaks down preferentially, IGF-1 rises, lean mass is protec=
ted. Tesamorelin triggers this cascade. So do the other secretagogues.</p><=
p style=3D"margin: 0 0 20px 0;color: rgb(54,55,55);line-height: 26px;font-s=
ize: 16px;">The question isn&#8217;t whether this mechanism exists. It does=
, and it&#8217;s well documented. The question is how effectively each comp=
ound triggers it, and for how long.</p><div style=3D"font-size: 16px;line-h=
eight: 26px;"><hr style=3D"margin: 32px 0;padding: 0;height: 1px;background=
: rgb(0,0,0,.1);border: none;"></div><p style=3D"margin: 0 0 20px 0;color: =
rgb(54,55,55);line-height: 26px;font-size: 16px;"><strong>The Other Secreta=
gogues: What We Actually Know</strong></p><p style=3D"margin: 0 0 20px 0;co=
lor: rgb(54,55,55);line-height: 26px;font-size: 16px;">Let&#8217;s go throu=
gh them one by one.</p><p style=3D"margin: 0 0 20px 0;color: rgb(54,55,55);=
line-height: 26px;font-size: 16px;"><strong>Sermorelin</strong></p><p style=
=3D"margin: 0 0 20px 0;color: rgb(54,55,55);line-height: 26px;font-size: 16=
px;">Sermorelin is the oldest GH secretagogue in widespread research use. L=
ike Tesamorelin, it&#8217;s a GHRH analogue &#8212; it works on the same re=
ceptor and through the same mechanism. The difference is half-life. Sermore=
lin is cleared from your body in about 10 to 12 minutes. It triggers a GH p=
ulse, and then it&#8217;s gone.</p><p style=3D"margin: 0 0 20px 0;color: rg=
b(54,55,55);line-height: 26px;font-size: 16px;">A 2001 study by Vittone and=
 colleagues looked at sermorelin in healthy older adults &#8212; a populati=
on with naturally declining GH &#8212; over six months. Fat mass decreased.=
 Lean mass increased. Visceral fat wasn&#8217;t the specific endpoint, so w=
e don&#8217;t have precise imaging data. But the directional result is exac=
tly what you&#8217;d expect given the mechanism.</p><p style=3D"margin: 0 0=
 20px 0;color: rgb(54,55,55);line-height: 26px;font-size: 16px;">The honest=
 limitation here is that 10 minutes may simply not be long enough to drive =
consistent, meaningful visceral fat mobilization over time. You&#8217;re ge=
tting a pulse, not sustained signaling.</p><p style=3D"margin: 0 0 20px 0;c=
olor: rgb(54,55,55);line-height: 26px;font-size: 16px;"><strong>CJC-1295</s=
trong></p><p style=3D"margin: 0 0 20px 0;color: rgb(54,55,55);line-height: =
26px;font-size: 16px;">CJC-1295 comes in two versions and they behave very =
differently, so it&#8217;s worth separating them.</p><p style=3D"margin: 0 =
0 20px 0;color: rgb(54,55,55);line-height: 26px;font-size: 16px;">CJC-1295 =
without DAC &#8212; sometimes called Mod GRF 1-29 &#8212; has a half-life o=
f around 30 minutes, putting it in the same range as Tesamorelin. It produc=
es a pulsatile GH response and is typically dosed multiple times per day.</=
p><p style=3D"margin: 0 0 20px 0;color: rgb(54,55,55);line-height: 26px;fon=
t-size: 16px;">CJC-1295 with DAC is a different animal. DAC stands for Drug=
 Affinity Complex &#8212; it&#8217;s a modification that allows the peptide=
 to bind to albumin, a protein that circulates in your blood, dramatically =
extending how long it stays active. Half-life stretches out to around 8 day=
s. Instead of a pulse, you get sustained, elevated GH over the better part =
of two weeks from a single injection.</p><p style=3D"margin: 0 0 20px 0;col=
or: rgb(54,55,55);line-height: 26px;font-size: 16px;">A 2006 pharmacology s=
tudy by Teichman and colleagues published in the Journal of Clinical Endocr=
inology and Metabolism showed that CJC-1295 produced dose-dependent, sustai=
ned increases in both GH and IGF-1 in healthy adults. Body composition wasn=
&#8217;t the primary focus &#8212; researchers were studying how the compou=
nd behaved in the body. But the hormonal environment it created is essentia=
lly identical to what Tesamorelin creates. The study just wasn&#8217;t desi=
gned to look at what happened to visceral fat.</p><p style=3D"margin: 0 0 2=
0px 0;color: rgb(54,55,55);line-height: 26px;font-size: 16px;"><strong>Ipam=
orelin</strong></p><p style=3D"margin: 0 0 20px 0;color: rgb(54,55,55);line=
-height: 26px;font-size: 16px;">Ipamorelin is a GHRP &#8212; a Growth Hormo=
ne Releasing Peptide &#8212; which means it works through a completely diff=
erent receptor than the GHRH analogues. It mimics ghrelin, a hormone that p=
owerfully stimulates GH release through its own separate pathway. When you =
combine a GHRH analogue with a GHRP, you hit both pathways simultaneously a=
nd get significantly more GH than either would produce alone &#8212; which =
is why CJC-1295 plus Ipamorelin became such a common research stack.</p><p =
style=3D"margin: 0 0 20px 0;color: rgb(54,55,55);line-height: 26px;font-siz=
e: 16px;">Ipamorelin&#8217;s half-life is roughly 2 hours, and it&#8217;s n=
otable for being the most cortisol-sparing of the GHRPs. That distinction m=
atters for this conversation. Cortisol &#8212; your primary stress hormone =
&#8212; is one of the main drivers of visceral fat accumulation. Some GHRPs=
, particularly GHRP-2 and GHRP-6 at higher doses, raise cortisol meaningful=
ly, which can actively work against visceral fat reduction. Ipamorelin larg=
ely avoids this, which theoretically makes it a cleaner option.</p><p style=
=3D"margin: 0 0 20px 0;color: rgb(54,55,55);line-height: 26px;font-size: 16=
px;">Dedicated visceral fat data doesn&#8217;t exist for Ipamorelin in huma=
ns. But the mechanism is there, the cortisol problem is largely absent, and=
 the GH response is real.</p><p style=3D"margin: 0 0 20px 0;color: rgb(54,5=
5,55);line-height: 26px;font-size: 16px;"><strong>MK-677 (Ibutamoren)</stro=
ng></p><p style=3D"margin: 0 0 20px 0;color: rgb(54,55,55);line-height: 26p=
x;font-size: 16px;">MK-677 is the outlier of the group. It&#8217;s taken or=
ally &#8212; no injection required &#8212; and has a half-life of around 24=
 hours, meaning it keeps GH and IGF-1 elevated throughout the day rather th=
an producing discrete pulses.</p><p style=3D"margin: 0 0 20px 0;color: rgb(=
54,55,55);line-height: 26px;font-size: 16px;">It actually has some of the b=
etter human data in this class. A 1998 study by Murphy and colleagues in th=
e Journal of Clinical Endocrinology and Metabolism showed MK-677 restored G=
H and IGF-1 to youthful levels in elderly adults with improvements in body =
composition. A 2008 study by Svensson and colleagues showed increased fat-f=
ree mass in GH-deficient adults. These aren&#8217;t visceral fat specific e=
ndpoints, but the direction is consistent.</p><p style=3D"margin: 0 0 20px =
0;color: rgb(54,55,55);line-height: 26px;font-size: 16px;">The complication=
 with MK-677 is that it&#8217;s a ghrelin mimetic &#8212; and ghrelin is yo=
ur hunger hormone. Most research subjects report a significant increase in =
appetite on MK-677, which in practice can offset fat loss outcomes. It&#821=
7;s also worth noting that chronic, around-the-clock GH elevation &#8212; a=
s opposed to the pulsatile release your body expects &#8212; may over time =
cause GH receptors to become less sensitive, potentially blunting the respo=
nse.</p><p style=3D"margin: 0 0 20px 0;color: rgb(54,55,55);line-height: 26=
px;font-size: 16px;"><strong>Hexarelin and GHRP-2</strong></p><p style=3D"m=
argin: 0 0 20px 0;color: rgb(54,55,55);line-height: 26px;font-size: 16px;">=
Most of the data here comes from animal studies. In rodent models, both com=
pounds have been associated with reductions in overall adiposity and improv=
ements in lipid metabolism. Hexarelin has also shown cardioprotective effec=
ts in animal models of GH deficiency that are worth noting separately. Huma=
n visceral fat data simply doesn&#8217;t exist for either compound &#8212; =
again, not because the biology doesn&#8217;t support it, but because no one=
 has funded the trial.</p><div style=3D"font-size: 16px;line-height: 26px;"=
><hr style=3D"margin: 32px 0;padding: 0;height: 1px;background: rgb(0,0,0,.=
1);border: none;"></div><p style=3D"margin: 0 0 20px 0;color: rgb(54,55,55)=
;line-height: 26px;font-size: 16px;"><strong>Why Tesamorelin Is Still Proba=
bly the Best Option for This Specific Goal</strong></p><p style=3D"margin: =
0 0 20px 0;color: rgb(54,55,55);line-height: 26px;font-size: 16px;">To be f=
air to the conventional wisdom: Tesamorelin isn&#8217;t just backed by evid=
ence because of luck or funding. There are legitimate biological reasons it=
 performs well for visceral fat specifically.</p><p style=3D"margin: 0 0 20=
px 0;color: rgb(54,55,55);line-height: 26px;font-size: 16px;">The half-life=
 sweet spot matters. At roughly 26 minutes, dosed daily, Tesamorelin produc=
es consistent pulsatile GH release that mirrors your body&#8217;s natural r=
hythm. This appears to be important. Your body expects GH in pulses &#8212;=
 it&#8217;s how the system evolved. Sustained, flat GH elevation can eventu=
ally trigger receptor downregulation, meaning your body becomes less respon=
sive over time. Tesamorelin avoids this by working with your physiology rat=
her than overriding it.</p><p style=3D"margin: 0 0 20px 0;color: rgb(54,55,=
55);line-height: 26px;font-size: 16px;">The cortisol issue is real. For the=
 GHRPs, cortisol elevation at higher doses is a genuine concern for anyone =
specifically targeting visceral fat. Cortisol and visceral fat accumulation=
 are closely linked &#8212; elevated cortisol drives fat deposition central=
ly, right where you&#8217;re trying to reduce it. Tesamorelin as a GHRH ana=
logue doesn&#8217;t have this problem. Neither does Ipamorelin, which is wh=
y it stands out from the other GHRPs.</p><p style=3D"margin: 0 0 20px 0;col=
or: rgb(54,55,55);line-height: 26px;font-size: 16px;">And the studied popul=
ation amplified the measurable effect. HIV lipodystrophy patients had sever=
ely, abnormally elevated visceral fat. A 15 to 18 percent reduction is a la=
rge signal that&#8217;s easy to detect statistically. In a metabolically he=
althier research subject, the starting visceral fat burden is lower, the ch=
ange will be smaller, and you&#8217;d need a larger, longer, more expensive=
 study to detect it reliably. This makes it harder to prove efficacy for ot=
her compounds even if the effect is real &#8212; it&#8217;s a statistical c=
hallenge, not a biological one.</p><div style=3D"font-size: 16px;line-heigh=
t: 26px;"><hr style=3D"margin: 32px 0;padding: 0;height: 1px;background: rg=
b(0,0,0,.1);border: none;"></div><p style=3D"margin: 0 0 20px 0;color: rgb(=
54,55,55);line-height: 26px;font-size: 16px;"><strong>The Honest Bottom Lin=
e</strong></p><p style=3D"margin: 0 0 20px 0;color: rgb(54,55,55);line-heig=
ht: 26px;font-size: 16px;">Tesamorelin has the clinical evidence. That&#821=
7;s not in question.</p><p style=3D"margin: 0 0 20px 0;color: rgb(54,55,55)=
;line-height: 26px;font-size: 16px;">What is worth questioning is the leap =
from &#8220;Tesamorelin has been studied for this&#8221; to &#8220;nothing =
else works for this.&#8221; That leap isn&#8217;t supported. The mechanism =
for visceral fat reduction &#8212; GH restoration driving preferential lipo=
lysis in visceral depots &#8212; is shared across this entire class of comp=
ounds. The studies that do exist for the others point in the same direction=
=2E The gap is in the research, not th=
e biology.</p><p style=3D"margin: 0 0 2=
0px 0;color: rgb(54,55,55);line-height: 26px;font-size: 16px;">We don&#8217=
;t know exactly how much visceral fat benefit Sermorelin, CJC-1295, Ipamore=
lin, or MK-677 provide because no one has designed a proper study to find o=
ut. That&#8217;s a funding and incentive problem in pharmaceutical research=
=2E It doesn&#8217;t mean the answer i=
s zero.</p><p style=3D"margin: 0 0 20px=
 0;color: rgb(54,55,55);line-height: 26px;font-size: 16px;">The most accura=
te thing you can say is: Tesamorelin is the best-evidenced option for visce=
ral fat reduction, it has legitimate biological advantages around half-life=
 and cortisol profile, and the other secretagogues almost certainly have me=
aningful overlap through the same mechanism &#8212; we just can&#8217;t qua=
ntify it yet.</p><p style=3D"margin: 0 0 20px 0;color: rgb(54,55,55);line-h=
eight: 26px;font-size: 16px;">That&#8217;s a very different statement than =
&#8220;the others don&#8217;t work.&#8221;</p><div style=3D"font-size: 16px=
;line-height: 26px;"><hr style=3D"margin: 32px 0;padding: 0;height: 1px;bac=
kground: rgb(0,0,0,.1);border: none;"></div><p style=3D"margin: 0 0 20px 0;=
color: rgb(54,55,55);line-height: 26px;font-size: 16px;"><strong>What I&#82=
17;m Actually Curious About</strong></p><p style=3D"margin: 0 0 20px 0;colo=
r: rgb(54,55,55);line-height: 26px;font-size: 16px;">This is the part I gen=
uinely don&#8217;t have a clean answer to, and I think it&#8217;s worth sit=
ting with.</p><p style=3D"margin: 0 0 20px 0;color: rgb(54,55,55);line-heig=
ht: 26px;font-size: 16px;">If you&#8217;ve run a longer protocol with CJC-1=
295, Ipamorelin, or MK-677 &#8212; did you track body composition with any =
precision? DEXA scans, waist circumference, anything consistent? And if you=
&#8217;ve run Tesamorelin specifically targeting visceral fat &#8212; did t=
he fat loss pattern feel different? Did it come off in a different place th=
an other secretagogue cycles you&#8217;ve run?</p><p style=3D"margin: 0 0 2=
0px 0;color: rgb(54,55,55);line-height: 26px;font-size: 16px;">The human tr=
ials may not exist yet. But the people actually running these protocols are=
 accumulating observations that matter. Not controlled data &#8212; but dir=
ectional signal worth paying attention to.</p><p style=3D"margin: 0 0 20px =
0;color: rgb(54,55,55);line-height: 26px;font-size: 16px;">If you have expe=
rience here, I&#8217;d genuinely like to hear it.</p><p style=3D"margin: 0 =
0 20px 0;color: rgb(54,55,55);line-height: 26px;font-size: 16px;">As always=
 &#8212; research use only.</p><div class=3D"subscribe-widget is-signed-up"=
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