What is the significance of the study by Al-Mrabeh et al. (2020)?
The study tracked participants from the DIRECT trial who maintained normal glucose control for over two years after intensive weight management. It confirmed the fat-deposition mechanism as a mediating variable in remission, showing that sustained reduction in liver and pancreatic fat is crucial for long-term success.
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This is one answer. The complete system — the psychology, the biology, and the method — is in the book.
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