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This is a common point of confusion because the tier numbering suggests exclusive ranges, but each tier is actually a minimum BMI plus a defined condition set, and the tiers can overlap

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Carnitine Support features Acetyl L-Carnitine the acetylated ester of the amino acid L-carnitine which plays a critical role in the transfer and utilization of long-chain fatty acids for cellular energy production.* It also supports the biosynthesis of acetylcholine, the most abundant neurotransmitter in the body, which regulates vital organ activity, blood vessel function, and nerve-to-muscle communication.*

J Diabet Invest 7(suppl 1):812