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These optimizations are difficult to implement, frequently error-prone, and lead to inconsistent behavior across runtimes. Bun's "Direct Streams" optimization takes a deliberately and observably non-standard approach, bypassing much of the spec's machinery entirely. Cloudflare Workers' IdentityTransformStream provides a fast-path for pass-through transforms but is Workers-specific and implements behaviors that are not standard for a TransformStream. Each runtime has its own set of tricks and the natural tendency is toward non-standard solutions, because that's often the only way to make things fast.
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Eli Lilly, the makers of Mounjaro, as well as Novo Nordisk, the makers of Wegovy and Saxenda, said that anyone who experiences side effects should talk to a doctor or healthcare professional.
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