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And then when you do eat, you are so hungry that you eat too much, too fast, triggering severe nausea and GI distress

Older people often have success with the injections, as do people who are smokers

Fasting insulin levels, HOMA-IR (a measure of insulin resistance), high-sensitivity C-reactive protein (an inflammation marker), liver enzymes (indicators of fatty liver disease), and advanced lipid panels all provide evidence of metabolic dysfunction that weight alone cannot capture

Either way, a clinic setting allows patients to explore their options with guidance from a medical team rather than making decisions on their own