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It could point to several things: A different cause: your fatigue might stem from thyroid problems, iron deficiency, or sleep apnea rather than B12

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Once that mechanism runs its course, or once the patient is off the medication, the underlying adipocyte metabolism is largely unchanged

PLoS One (2015) 10(7):e0132744.10.1371/journal.pone.0132744 30 PereiraMJeyabalanJJorgensenCSHopkinsonMAl-JazzarARouxJPet alChronic administration of glucagon-like peptide-1 receptor agonists improves trabecular bone mass and architecture in ovariectomised mice

As was mentioned earlier, IGF-1 and its cohorts tend to increase oxidative stress