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One critical point that many people miss

Sleep, stress, and life Poor sleep increases hunger hormones (ghrelin) and reduces fullness hormones (GLP-1, CCK, PYY)

The small intestine isnt designed for this large number of bacteria

However, currently the use of GLP-1 RAs is not recommended as treatment of MASLD.(3) The American Diabetes Association 2025 guidelines similarly state GLP-1 RAs are recommended in adults with diabetes, obesity, and MASLD in combination with diet and exercise for weight loss

Several peptides being studied have mechanisms that directly address this core problem: they promote new blood vessel formation (angiogenesis), reduce the inflammatory cascade that accelerates disc breakdown, and stimulate the cellular repair processes needed to rebuild damaged disc structures