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In addition to its adverse cosmetic and psychological effects, obesity has been linked to several metabolic disorders (Table 1), including T2DM, hypertension, and metabolic dysfunction-associated fatty liver disease (2, 151)

Carnitine participates in cell volume and fluid balancing in all tissues that are affected by the tonicity (iso-, hyper- hypo- tonicity) of the extracellular environment [19]

And probably that started a cascade of gut symptoms and things

In summary, SCLA1, SCLA2 and SCLA3 induced ferroptosis, which correlated with the identification of GPX4 as a target for these SCLAs in pulldown experiments and senescence selectivity of engagement with these SCLAs

The level of pancreatic cholesterol in the T2DM and T2DM + sham group was markedly higher than the NC group, while compared to the T2DM + sham group, pancreatic cholesterol level dramatically decreased in T2DM + RYGB and T2DM + EX-4 groups (Figure 6J)