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PubMed Central, Zhao, Wenmei, et al

Increased cellular energy Higher NAD+ levels translate directly to improved cellular energy production

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Conclusion This case report demonstrates that the combination of prolonged water fasting and a GLP-1 receptor agonist is a safe and effective method for short-term substantial weight loss in patients with severe obesity for the purpose of pre-procedural optimization prior to bariatric surgery, and may result in the improvement of multiple chronic diseases including hypertension, insulin resistance, anemia, depression, and diastolic heart failure

However, the 4-6 hour effect duration allows multiple encounters within the window, and experience helps dial in personal timing patterns for optimal results