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Increased VO2 max with right-shifted Hb-O2 dissociation curve at a constant O2 delivery in dog muscle in situ

This may reflect the rapid metabolic changes happening during significant weight loss rather than a direct pharmacological side effect

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This effect is believed to be due to IGF-1 suppression of insulin secretion, which leads to augmented lipolysis in adipose tissue and promotion of FFA use by muscle