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"Not FDA-approved" just means the FDA hasn't reviewed or signed off on its safety, efficacy, dosing, or manufacturing for people

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As fat tissue grows and more NNMT is produced, higher amounts of hormones and pro-inflammatory signals are produced that are responsible for weight gain and other chronic diseases such as type 2 diabetes and cardiovascular disease. NNMT is responsible for converting nicotinamide (NA) into 1-methylnicotinamide (1-MNA), which takes it out of the NAD salvage pathway (see the diagram below)

Fourteen of sixteen patients (87.5%) experienced significant pain relief