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FIGURE 1 2 Literature search strategy To support the narrative synthesis, a focused literature search was conducted across PubMed, Web of Science, ScienceDirect, and SpringerLink, targeting English-language, peer-reviewed articles published between 2010 and 2025

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Separately and in combination, each of these factors presented daunting challenges to successful synthesis

For patients with obesity-related GI conditions such as MASLD, these medications are best viewed as part of a broader strategy for managing metabolic disease rather than choosing between them based on weight loss alone, particularly as longer-term safety and outcomes data continue to evolve. Further research will help clarify long-term comparative effectiveness and patterns of medication persistence in routine care

Expected results Results from NAD+ IV Therapy vary between patients