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Based on current clinical evidence, the rough ordering from largest to smallest weight-loss effect is: Tirzepatide highest average weight loss Semaglutide significant weight loss Tesamorelin moderate weight loss, primarily through visceral fat reduction AOD-9604 primarily body composition effects MOTS-c primarily metabolic and energy effects rather than pure weight reduction AOD-9604 and MOTS-c are generally not considered replacements for GLP-1 medications in patients seeking substantial weight reduction

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This restoration of metabolic cofactor availability enables enhanced function of NAD+-dependent enzymes including sirtuins, poly(ADP-ribose) polymerases, and various deacetylases that regulate cellular metabolism, stress responses, and aging processes