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Intensive behavioral therapy, combined with the appropriate treatment regimen of tirzepatide, has shown average weight reductions that are significantly greater than other weigh loss medications

J Stroke Cerebrovasc Dis 28(2):441449 Corvest V, Blais S, Dahmani B, De Tersant M, Etienney AC, Maroni A, Ormires C, Roussel A, Pondarr C (2018) Vasculopathie crbrale de lenfant drpanocytaire : points cls et nouveauts [Cerebral vasculopathy in children with sickle cell disease: Key issues and the latest data]

10.1038/cdd.2016.25 71

The early sundowning was confirmed by additional family members and the primary author's observations on multiple occasions during the summer of 2019 while traveling on the same route to his vacation home in Nebraska for weekend trips (3,330 ft., 0.89 ATA)