Yes. Tesa doesn’t actually induce any weight loss.
Mechanically what it’s doing is “unlocking” visceral fat that can become extremely resistant to weight loss, especially over 30-35. That’s why you can see relatively lean guys with a protruding gut.
Visceral fat ends up becoming resistant to growth hormone (the hormone that tells adipocyte cells to release their stored free fatty acids). At the same time they become more sensitive to insulin (the free fatty acid storage signal), so visceral fat ends up being the first place excess calories are stored and the last they’re released from.
Tesa essentially kicks the door in and visceral free fatty acids (FFAs) are rapidly released. If you’re not in a calorie deficit via exercise or diet, those FFA’s will be put back into fat storage, but it’ll be elsewhere, in subcutaneous fat, which is healthier (visceral fat is very harmful), and tends to look much better. That’s the mechanism of Tesa induced recomposition, something GLPs don’t do.
Tesa is actually best paired with a GLP, so you’re in a calorie deficit and and as the FFAs are released from your gut fat they’re used for energy instead of being redeposited. Either way, with or without weight loss, the gut will shrink over time.
(And yes, rHGH can do the same thing, but because of continuous GH exposure, visceral fat receptors downregulate and you need a fairly high, side effect / insulin resistance inducing dose of rHGH to achieve the same results of Tesa, which releases GH in short, intense pulses that don’t cause the receptors to downregulate.).