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Because lipid accumulation, lipotoxicity, oxidative stress, and ER stress all appear to be fundamental drivers of NASH pathogenesis, FGF21-based therapies may be broadly useful in a potentially heterogeneous NASH patient population

Esteban N, Gopalareddy VG, Singh D

Plus, rapid weight loss (more than about 3 pounds per week sustained) is associated with greater muscle loss, a higher risk of nutrient deficiencies, an increased risk of gallstones, and a much higher likelihood of regaining weight afterward

Despite showing an increase in SIBO likelihood, the numbers were minimal (fewer than 0.02%), and the study did not prove causation, only a correlation based on a yes/no diagnosis