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It rarely hurts and often helps

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The two medications work through entirely different mechanisms phentermine through central stimulant pathways, GLP-1s through appetite and metabolic signaling which is precisely why combining them can restart progress when either alone has stalled

With regards to subacromial impingement the pathology involves a rotator cuff dysfunction resulting in a mechanical impingement and compression of the subacromial bursa between the rotator cuff and the acromion and coracocromial ligament