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No published human trial has measured outcomes for cagrilintide + retatrutide as a stack

In mice, knockout of ChREBP has been shown to reduce hepatic fatty acid synthesis by 65% compared to wild-type controls, but also to promote insulin resistance, delayed glucose clearance, and severe intolerance to simple carbohydrates, such as sucrose and fructose (resulting in death in the majority of animals) due to an inability to shunt fructose into glycolytic pathways [48]

Regulation of gamma-glutamylcysteine synthetase subunit gene expression by the transcription factor Nrf2

This adds metabolic burden and increases oxidative stress