It functions as a highly specific inhibitor of an enzyme called NNMT (Nicotinamide N-methyltransferase)
Oral vs injection
It targets two appetite hormones instead of one, producing more weight loss in clinical trials: 22.5% of body weight over 72 weeks
[DOI] [PubMed] [Google Scholar] 37.Lojo N., Rasic Z., Sever A.Z., Kolenc D., Vukusic D., Drmic D., Zoricic I., Sever M., Seiwerth S., Sikiric P
Since NNMT is expressed in adipose, hepatic, and gut tissues 50,51,52 , and these tissues heavily cross-talk with the gut microbiome 53,54,55 , NNMTi treatment or its resulting weight loss effects 8,9 may modulate the microbiome
They serve different situations, different tolerances for side effects, and different magnitudes of weight loss goals