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Furthermore, direct comparisons of GLP-1RAs and exercise in diverse populations are scarce, and evidence on optimal sequencing, duration, and integration of hybrid interventions remains limited ( Beyond physiological adaptations, treatment adherence and long-term success largely depend on motivation, self-efficacy, and body-image perception, which may fluctuate during pharmacologic weight loss ( Future research should focus on refining hybrid strategies, optimizing dose-exercise combinations, and addressing health equity and implementation barriers

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