Adiposuppression: Silencing the Tyrant Organ with Dual/Triple Incretin Agonists

Hypertrophic adipose tissue acts as a rogue, tumour-like endocrine organ, constitutively secreting pathogenic adipokines while suppressing protective ones, thereby driving insulin resistance, inflammation, hypertension, osteoarthritis, type 2 diabetes, hypogonadism, sarcopenia, and accelerated ageing. Tirzepatide, the first dual GLP-1/GIP agonist, reducing the adipose tissue, can yield profound benefits via mechanical unloading, pharmacodynamic amplification, functional rejuvenation, and direct endocrine silencing, leading to leptin sensitisation, and adiponectin rise, cytokine suppression, testosterone normalisation, reduced local cortisol/angiotensinogen. Consequences include biological age reversa, avoided joint replacements, polypharmacy reduction, and resolution of multimorbidity.