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They work by suppressing appetite, slowing gastric emptying, increasing insulin sensitivity, and regulating blood glucose levels

581(Pt 2): 431-44 New insights concerning the role of carnitine in the regulation of fuel metabolism in skeletal muscleFrancis B Stephens, Dumitru Constantin-Teodosiu, and Paul L Greenhaff Ann N Y Acad Sci

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Even more impressive: They kept the weight off

Possible causes: dead space accumulation (discussed above), inaccurate water volume at reconstitution (more water means more dilute, means more volume per dose, means fewer doses from the same amount of peptide), or air in the vial displacing solution