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Intermittent Fasting or Ozempic: Exploring their Impact on Weight Loss and Metabolic Health

Shamreen Naaz

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International Physiology 13(1):p 41-51, Jan-June 2025. | DOI: https://doi.org/ 10.21088/ip.2347.1506.13125.5

How Cite This Article:

Shamreen Naaz. Intermittent Fasting or Ozempic: Exploring their Impact on Weight Loss and Metabolic Health. Int.Phy. 2025; 13(1): 41–51.

Timeline

Received : February 26, 2025         Accepted : May 20, 2025          Published : June 27, 2025

Abstract

Intermittent Fasting (IF) has gained widespread popularity particularly due to its remarkable effects on weight loss and regulation of metabolic homeostasis. Although it became a recent trend, its benefits have been documented in a number of studies including hepatic steatosis, cardiovascular diseases, diabetes as well as cancer. Ozempic®, the brand name of Glucagon like Peptide-1(GLP-1) receptor agonists or semaglutide, has attracted attention from celebrities and social media due to its “miraculous” effect of weight loss. Although it was originally developed as a treatment for Type–2 diabetes, as it mimics the hormone glucagonlike peptide-1 in the body, its side effect of weight loss has now become a more dominating feature. Although both these methods result in weight loss, however, IF focuses primarily on calorie restriction and metabolic regulation whereas Ozempic® works by suppression of appetite and inducing a feeling of fullness through GLP-1 receptor agonists. Studies have shown that IF provides a natural form of metabolic regulation through maintenance of circadian rhythm and increased insulin sensitivity, thereby reducing the insulin resistance and promoting liver health and detoxification. Evidences suggesting the effectiveness of GLP-1 receptor agonists in lowering glycosylated hemoglobin (HbA1c) in Type 2 diabetes along with its “off-label” use as a weight loss drug have gained attention and more research is being carried out to understand and comprehend the magnitude of its efficacy. This review presents a comparative analysis between IF and GLP-1 receptor agonist (Ozempic®) as a method of weight loss and illustrates upon it prevalent use worldwide.


References

  • 1.   Misra A., Jayawardena R., Anoop S. Obesity in South Asia: phenotype, morbidities, and mitigation. Current Obesity Reports 2019 Mar 15; 8(1): 43-52.
  • 2.   Hills A.P., Arena R., Khunti K., Yajnik C.S., Jayawardena R., Henry C.J., Street S.J., Soares M.J., Misra A. Epidemiology and determinants of type 2 diabetes in south Asia. The lancet Diabetes & endocrinology 2018; 6(12): 966-78.
  • 3.   Malinowski B., Zalewska K., Węsierska A., Sokołowska M.M., Socha M., Liczner G., Pawlak-Osińska K., Wiciński M. Intermittent fasting in cardiovascular disorders—an overview. Nutrients 2019; 11(3): 673.
  • 4.   Brandhorst S., Longo V.D. Dietary restrictions and nutrition in the prevention and treatment of cardiovascular disease. Circulation research 2019; 124(6): 952-65.
  • 5.   Johnstone A. Fasting for weight loss: an effective strategy or latest dieting trend?. International Journal of Obesity 2015; 39(5): 727-33.
  • 6.   Stekovic S., Hofer S.J., Tripolt N., Aon M.A., Royer P., Pein L, Stadler J.T., Pendl T., Prietl B., Url J., Schroeder S. Alternate day fasting improves physiological and molecular markers of aging in healthy, non-obese humans. Cell metabolism 2020; 31(4): 878-81.
  • 7.   Varady K.A., Hellerstein M.K. Alternateday fasting and chronic disease prevention: a review of human and animal trials. The American journal of clinical nutrition 2007;
  • 8.   Cho A.R., Moon J.Y., Kim S., An K.Y., Oh M., Jeon J.Y., Jung D.H., Choi M.H., Lee J.W. Effects of alternate day fasting and exercise on cholesterol metabolism in overweight or obese adults: A pilot randomized controlled trial. Metabolism 2019; 93: 52-60.
  • 9.   Trepanowski J.F., Kroeger C.M., Barnosky A., Klempel M.C., Bhutani S., Hoddy K.K., Gabel K., Freels S., Rigdon J., Rood J., Ravussin E. Effect of alternate-day fasting on weight loss, weight maintenance, and cardioprotection among metabolically healthy obese adults: a randomized clinical trial. JAMA internal medicine 2017; 177(7): 930-8.
  • 10.   Gabel K., Varady K.A. Alternate Day Fasting and the 5: 2 Diet: Effects on Body Weight and Metabolic Disease Risk Factors. In Intermittent and Periodic Fasting, Aging and Disease 2024; 143-176.
  • 11.   Schübel R., Nattenmüller J., Sookthai D., Nonnenmacher T., Graf ME, Riedl L., Schlett C.L., Von Stackelberg O., Johnson T., Nabers D., Kirsten R. Effects of intermittent and continuous calorie restriction on body weight and metabolism over 50 wk: a randomized controlled trial. The American journal of clinical nutrition 2018; 108(5): 933-45.
  • 12.   Carter S., Clifton P.M., Keogh J.B. Effect of intermittent compared with continuous energy restricted diet on glycemic control in patients with type 2 diabetes: a randomized
  • 13.   Heilbronn L.K., Smith S.R., Martin C.K., Anton S.D., Ravussin E. Alternate-day fasting in nonobese subjects: effects on body weight, body composition, and energy metabolism1, 2. The American journal of clinical nutrition 2005; 81(1): 69-73.
  • 14.   Byrne N.M., Sainsbury A., King N.A., Hills A.P., Wood R.E.. Intermittent energy restriction improves weight loss efficiency in obese men: the MATADOR study. International journal of obesity 2018; 42(2): 129-38.
  • 15.   Eshghinia S., Mohammadzadeh F. The effects of modified alternate-day fasting diet on weight loss and CAD risk factors in overweight and obese women. Journal of Diabetes & Metabolic Disorders 2013; 12: 1-4.
  • 16.   Klempel M.C., Kroeger C.M., Varady K.A. Alternate day fasting (ADF) with a highfat diet produces similar weight loss and cardio-protection as ADF with a low-fat diet. Metabolism 2013; 62(1): 137-43.
  • 17.   Franz M.J., VanWormer J.J., Crain A.L., Boucher J.L., Histon T., Caplan W., Bowman J.D., Pronk N.P. Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. Journal of the American Dietetic association 2007; 107(10): 1755-67.
  • 18.   Lumeng C.N., Saltiel A.R. Inflammatory links between obesity and metabolic disease. The Journal of clinical investigation 2011; 121(6): 2111-7.
  • 19.   Chalasani N., Younossi Z., Lavine J.E., Charlton M., Cusi K., Rinella M., Harrison S.A., Brunt E.M., Sanyal A.J. The diagnosis and management of nonalcoholic fatty liver
  • 20.   Huang D.Q., El-Serag H.B., Loomba R. Global epidemiology of NAFLD-related HCC: trends, predictions, risk factors and prevention. Nature reviews Gastroenterology & hepatology 2021; 18(4): 223-38.
  • 21.   Younossi Z.M., Corey K.E., Lim J.K. AGA clinical practice update on lifestyle modification using diet and exercise to achieve weight loss in the management of nonalcoholic fatty liver disease: expert review. Gastroenterology 2021; 160(3): 912-8.
  • 22.   Anderson J.W., Konz E.C., Frederich R.C., Wood C.L. Long-term weight-loss maintenance: a meta-analysis of US studies. The American journal of clinical nutrition 2001;
  • 23.   Clifton K.K., Ma C.X., Fontana L., Peterson L.L. Intermittent fasting in the prevention and treatment of cancer. CA: a cancer journal for clinicians 2021; 71(6): 527-46.
  • 24.   Christensen R.A., Kirkham A.A. Timerestricted eating: A novel and simple dietary intervention for primary and secondary prevention of breast cancer and cardiovascular disease. Nutrients 2021;13(10):3476.
  • 25.   Gudden J., Arias Vasquez A., Bloemendaal M. The effects of intermittent fasting on brain and cognitive function. Nutrients 2021;13(9):3166.
  • 26.   Gabel K., Kroeger C.M., Trepanowski J.F., Hoddy K.K., Cienfuegos S., Kalam F., Varady KA. Differential effects of alternate‐day fasting versus daily calorie restriction on insulin resistance. Obesity 2019;27(9):1443-50.
  • 27.   Overland J., Toth K., Gibson A.A., Sainsbury A, Franklin J., Gauld A., Wong J. The safety and efficacy of weight loss via intermittent fasting or standard daily energy restriction in adults with type 1 diabetes and overweight or obesity: A pilot study. Obesity Medicine 2018; 12: 13-7.
  • 28.   Yeoh E.C., Zainudin S.B., Loh W.N., Chua C.L., Fun S., Subramaniam T., Sum C.F., Lim S.C. Fasting during Ramadan and associated changes in glycaemia, caloric intake and
  • 29.   Aksungar F.B., Eren A, Ure S., Teskin O., Ates G. Effects of intermittent fasting on serum lipid levels, coagulation status and plasma homocysteine levels. Annals of nutrition and metabolism 2005; 49(2): 77-82.
  • 30.   Aksungar F.B., Topkaya A.E., Akyildiz M. Interleukin-6, C-reactive protein and biochemical parameters during prolonged intermittent fasting. Annals of Nutrition and Metabolism 2007; 51(1): 88-95.
  • 31.   Kacimi S., Ref’at A, Fararjeh M.A., Bustanji Y.K., Mohammad M.K., Salem M.L. Intermittent fasting during Ramadan attenuates proinflammatory cytokines and immune cells
  • 32.   Cienfuegos S., Gabel K., Kalam F., Ezpeleta M., Wiseman E., Pavlou V., Lin S., Oliveira M.L., Varady K.A. Effects of 4-and 6-h time-restricted feeding on weight and cardiometabolic health: a randomized controlled trial in adults with obesity. Cell metabolism 2020;32(3):366-78.
  • 33.   Johnson J.B., Summer W., Cutler R.G., Martin B., Hyun D.H., Dixit V.D., Pearson M., Nassar M, Tellejohan R., Maudsley S., Carlson O. Alternate day calorie restriction improves clinical findings and reduces markers of oxidative stress and inflammation in overweight adults with moderate asthma. Free Radical Biology and Medicine 2007; 42(5): 665-74.
  • 34.   Patikorn C., Roubal K., Veettil S.K., Chandran V., Pham T., Lee Y.Y., Giovannucci E.L., Varady K.A., Chaiyakunapruk N. Intermittent fasting and obesity-related health outcomes: an umbrella review of meta-analyses of randomized clinical trials. JAMA network open 2021; 4(12): e2139558.
  • 35.   Harvie M.N., Pegington M., Mattson M.P., Frystyk J., Dillon B., Evans G., Cuzick J., Jebb S.A., Martin B., Cutler R.G., Son T.G. The effects of intermittent or continuous energy
  • 36.   Harvie M., Wright C., Pegington M, McMullan D., Mitchell E., Martin B., Cutler R.G., Evans G., Whiteside S., Maudsley S., Camandola S. The effect of intermittent energy and carbohydrate restriction v. daily energy restriction on weight loss and metabolic disease risk markers in overweight women. British Journal of Nutrition 2013; 110(8): 1534-47.
  • 37.   Mayor E. Neurotrophic effects of intermittent fasting, calorie restriction and exercise: a review and annotated bibliography. Frontiers in Aging 2023; 4: 1161814.
  • 38.   Cherif A., Roelands B., Meeusen R., Chamari K. Effects of intermittent fasting, caloric restriction, and Ramadan intermittent fasting on cognitive performance at rest and during exercise in adults. Sports medicine 2016; 46:35-47.
  • 39.   Dong T.A., Sandesara PB, Dhindsa D.S., Mehta A., Arneson L.C., Dollar A.L., Taub PR, Sperling LS. Intermittent fasting: a heart healthy dietary pattern?. The American journal of medicine 2020; 133(8): 901-7.
  • 40.   Strilbytska O., Klishch S., Storey KB, Koliada A., Lushchak O. Intermittent fasting and longevity: From animal models to implication for humans. Ageing research reviews 2024: 102274.
  • 41.   De Cabo R., Mattson M.P. Effects of intermittent fasting on health, aging, and disease. New England Journal of Medicine 2019; 381(26): 2541-51.
  • 42.   Chausse B., Vieira-Lara M.A., Sanchez A.B., Medeiros M.H., Kowaltowski A.J. Intermittent fasting results in tissue-specific changes in bioenergetics and redox state. PLoS One 2015; 10(3): e0120413.
  • 43.   Mattson M.P. Challenging oneself intermittently to improve health. DoseResponse 2014; 12(4): dose-response.
  • 44.   Johnson J.B, Laub D.R., John S. The effect on health of alternate day calorie restriction: eating less and more than needed on alternate days prolongs life. Medical hypotheses 2006; 67(2): 209-11.
  • 45.   Longo V.D., Mattson M.P. Fasting: molecular mechanisms and clinical applications. Cell metabolism 2014; 19(2): 181-92.
  • 46.   Maalouf M., Rho J.M., Mattson M.P. The neuroprotective properties of calorie restriction, the ketogenic diet, and ketone bodies. Brain research reviews 2009; 59(2):293-
  • 315.  
  • 47.   Masiero E., Agatea L., Mammucari C., Blaauw B., Loro E., Komatsu M., Metzger D., Reggiani C., Schiaffino S., Sandri M. Autophagy is required to maintain muscle mass. Cell
  • 48.   Mattson M.P. Energy intake and exercise as determinants of brain health and vulnerability to injury and disease. Cell metabolism 2012;16(6):706-22.
  • 49.   Marosi K., Mattson M.P. BDNF mediates adaptive brain and body responses to energetic challenges. Trends in Endocrinology & Metabolism 2014; 25(2): 89-98.
  • 50.   Ahlskog J.E., Geda Y.E., Graff-Radford NR, Petersen R.C. Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging. InMayo clinic proceedings 2011; 86(9): 876-884.
  • 51.   Mattson M.P. Evolutionary aspects of human exercise—born to run purposefully. Ageing research reviews 2012; 11(3): 347-52.
  • 52.   Mattson M.P., Longo V.D., Harvie M. Impact of intermittent fasting on health and disease processes. Ageing research reviews 2017; 39: 46-58.
  • 53.   Singh G., Krauthamer M., Bjalme-Evans M. Wegovy (semaglutide): a new weight loss drug for chronic weight management. Journal of Investigative Medicine 2022;70(1):5-13.
  • 54.   Cornell S. A review of GLP‐1 receptor agonists in type 2 diabetes: a focus on the mechanism of action of once‐weekly agents. Journal of clinical pharmacy and therapeutics 2020;45:17-27.
  • 55.   Merchenthaler I., Lane M., Shughrue P. Distribution of pre‐pro‐glucagon and glucagon‐like peptide‐1 receptor messenger RNAs in the rat central nervous system. Journal
  • 56.   Pyke C., Heller R.S., Kirk R.K., Ørskov C., Reedtz-Runge S., Kaastrup P., Hvelplund A., Bardram L., Calatayud D., Knudsen L.B. GLP-1 receptor localization in monkey and human tissue: novel distribution revealed with extensively validated monoclonal antibody. Endocrinology 2014;155(4):1280-90.
  • 57.   Nauck M.A., Heimesaat M.M., Behle K.A., Holst J.J., Nauck M.S., Ritzel R., Hüfner M., Schmiegel WH. Effects of glucagon-like peptide 1 on counterregulatory hormone responses, cognitive functions, and insulin secretion during hyperinsulinemic, stepped hypoglycemic clamp experiments in healthy volunteers. The Journal of Clinical Endocrinology & Metabolism 2002; 87(3): 1239-46.
  • 58.   Meier J.J. GLP-1 receptor agonists for individualized treatment of type 2 diabetes mellitus. Nature Reviews Endocrinology 2012; 8(12): 728-42.
  • 59.   Ard J., Fitch A., Fruh S., Herman L. Weight loss and maintenance related to the mechanism of action of glucagon-like peptide 1 receptor agonists. Advances in therapy 2021; 38(6): 2821-39.
  • 60.   Gabery S., Salinas C.G., Paulsen S.J., AhnfeltRønne J., Alanentalo T., Baquero A.F., Buckley S.T., Farkas E., Fekete C, Frederiksen KS, Hogendorf W.F. Semaglutide lowers body
  • 61.   Montecinos K., Kania B., Goldberg D.J. Semaglutide “Ozempic” Face and Implications in Cosmetic Dermatology. Dermatological Reviews 2024; 5(5): e70003.
  • 62.   Hach M., Engelund D.K, Mysling S., Mogensen J.E., Schelde O., Haselmann K.F., Lamberth K., Vilhelmsen T.K., Malmstrøm J., Højlys-Larsen K.B., Rasmussen TS. Impact of manufacturing process and compounding on properties and quality of follow-On GLP-1 polypeptide drugs. Pharmaceutical Research 2024;41(10):1991-2014.
  • 63.   O’Neil P.M., Birkenfeld A.L., McGowan B., Mosenzon O., Pedersen S.D., Wharton S., Carson C.G., Jepsen C.H., Kabisch M., Wilding J.P. Efficacy and safety of semaglutide
  • 64.   Wegovy (semaglutide) injection 2.4 mg. https://www.novopi.com/wegovy.pdf.
  • 65.   Marso S.P, Bain S.C., Consoli A., Eliaschewitz F.G., Jódar E, Leiter L.A., Lingvay I., Rosenstock J., Seufert J., Warren M.L., Woo V. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. New England Journal of Medicine 2016; 375(19): 1834-44.
  • 66.   Ryan D.H., Lingvay I., Colhoun H.M., Deanfield J., Emerson S.S., Kahn S.E., Kushner R.F., Marso S., Plutzky J., Brown-Frandsen K., Gronning M.O. Semaglutide effects on
  • 67.   Pearl R.L., Wadden T.A., Tronieri J.S., Berkowitz R.I., Chao A.M., Alamuddin N., Leonard SM, Carvajal R., Bakizada Z.M., Pinkasavage E, Gruber K.A. Short‐and long‐term changes in health‐related quality of life with weight loss: Results from a randomized controlled trial. Obesity 2018; 26(6): 985-91.
  • 68.   Wadden T.A., Tsai A.G., Tronieri J.S. A protocol to deliver intensive behavioral therapy (IBT) for obesity in primary care settings: the MODEL‐ IBT program. Obesity 2019; 27(10): 1562-6.
  • 69.   Wadden T.A., Berkowitz R.I., Womble L.G., Sarwer D.B., Phelan S., Cato R.K., Hesson L.A., Osei S.Y., Kaplan R., Stunkard AJ. Randomized trial of lifestyle modification and
  • 70.   Kelley D.E., Bray G.A., Pi-Sunyer F.X., Klein S., Hill J., Miles J., Hollander P. Clinical efficacy of orlistat therapy in overweight and obese patients with insulin-treated type 2 diabetes: a 1-year randomized controlled trial. Diabetes care 2002; 25(6): 1033-41.
  • 71.   Hussein H., Zaccardi F., Khunti K, Davies M.J., Patsko E., Dhalwani N.N, Kloecker DE, Ioannidou E, Gray LJ. Efficacy and tolerability of sodium‐glucose co‐transporter‐2 inhibitors and glucagon‐like peptide‐1 receptor agonists: a systematic review and network meta‐ analysis. Diabetes, obesity and metabolism 2020; 22(7): 1035-46.
  • 72.   Elashoff M., Matveyenko A.V., Gier B., Elashoff R., Butler P.C. Pancreatitis, pancreatic, and thyroid cancer with glucagon-like peptide-1–based therapies. Gastroenterology 2011; 141(1): 150-6.
  • 73.   Korsatko S., Jensen L., Brunner M., Sach‐Friedl S., Tarp M.D., Holst A.G., Heller S.R., Pieber TR. Effect of once‐weekly semaglutide on the counterregulatory response to hypoglycaemia in people with type 2 diabetes: A randomized, placebo‐controlled, double‐blind, crossover trial. Diabetes, Obesity and Metabolism 2018; 20(11): 2565-73.
  • 74.   Mosenzon O., Blicher T.M., Rosenlund S., Eriksson J.W., Heller S., Hels O.H., Pratley R., Sathyapalan T., Desouza C., Abramof R., Alpenidze D. Efficacy and safety of oral semaglutide in patients with type 2 diabetes and moderate renal impairment (PIONEER 5): a placebo-controlled, randomised, phase 3a trial. The lancet Diabetes & ndocrinology 2019; 7(7): 515-27.
  • 75.   Pi-Sunyer X., Astrup A., Fujioka K., Greenway F., Halpern A., Krempf M., Lau D.C., Le Roux C.W., Violante Ortiz R., Jensen C.B., Wilding JP. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. New England Journal of Medicine 2015; 373(1): 11-22.
  • 76.   Tsapas A., Avgerinos I., Karagiannis T., Malandris K., Manolopoulos A., Andreadis P., Liakos A., Matthews DR, Bekiari E. Comparative effectiveness of glucose-lowering
  • 77.   Marchesini G., Bugianesi E., Forlani G., Cerrelli F, Lenzi M., Manini R.., Natale S., Vanni E., Villanova N., Melchionda N., Rizzetto M. Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome. Hepatology 2003; 37(4): 917-23.
  • 78.   Newsome P., Francque S., Harrison S., Ratziu V., Van Gaal L., Calanna S., Hansen M., Linder M., Sanyal A. Effect of semaglutide on liver enzymes and markers of inflammation in subjects with type 2 diabetes and/or obesity. Alimentary pharmacology & therapeutics 2019; 50(2): 193-203.
  • 79.   Marso S.P., Bain S.C., Consoli A., Eliaschewitz F.G., Jódar E, Leiter L.A., Lingvay I., Rosenstock J., Seufert J., Warren M.L, Woo V. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. New England Journal of Medicine 2016; 375(19): 1834-44.
  • 80.   Wojtara M., Mazumder A., Syeda Y., Mozgała N. Glucagon‐like Peptide‐1 receptor agonists for chronic weight management. Advances in Medicine 2023; 2023(1): 9946924.
  • 81.   Biddinger J.E., Lazarenko R.M., Scott M.M., Simerly R. Leptin suppresses development of GLP-1 inputs to the paraventricular nucleus of the hypothalamus. Elife 2020; 9: e59857.
  • 82.   Angelini G., Russo S., Mingrone G. Incretin hormones, obesity and gut microbiota. Peptides 2024; 178: 171216.
  • 83.   Lebrun L.J., Lenaerts K., Kiers D., de Barros J.P., Le Guern N., Plesnik J., Thomas C., Bourgeois T., Dejong C.H., Kox M., Hundscheid I.H. Enteroendocrine L. cells sense LPS after gut barrier injury to enhance GLP-1 secretion. Cell reports 2017; 21(5): 1160-8.

Data Sharing Statement

There are no additional data available. All raw data and code are available upon request.

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This research received no funding.

Author Contributions

All authors contributed significantly to the work and approve its publication.

Ethics Declaration

This article does not involve any human or animal subjects, and therefore does not require ethics approval.

Acknowledgements

We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.

Conflicts of Interest

No conflicts of interest in this work.


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Shamreen Naaz. Intermittent Fasting or Ozempic: Exploring their Impact on Weight Loss and Metabolic Health. Int.Phy. 2025; 13(1): 41–51.


Licence:

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.


Received Accepted Published
February 26, 2025 May 20, 2025 June 27, 2025

DOI: https://doi.org/ 10.21088/ip.2347.1506.13125.5

Keywords

Intermittent fasting • Ozempic • Weight loss • Metabolic healthIntermittent fastingOzempicWeight lossMetabolic health

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Received February 26, 2025
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Published June 27, 2025

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