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A detailed analysis of the antiobesity action of fenfluramine disclosed that it directly activates hypothalamic POMC neurons through 5-hydroxytryptamine 2C (5-HT2C) receptors that are expressed on a majority of these cells [80]

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That action spares nicotinamide for NAD+ production and preserves SAM, which in cell and animal studies translates to reduced fat storage, smaller fat cells, and higher cellular energy output