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Weight gain evokes proportionate increases in catabolic hormones and decreases ghrelin, whereas weight loss causes the opposite [5]
Other long-term considerations include gastrointestinal adaptation (most patients find side effects diminish significantly after the first 3-6 months), nutritional deficiencies that can develop with prolonged reduced caloric intake, and the psychological adjustment of maintaining a dramatically different body weight and relationship with food
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Metformin reduces B12 absorption in the small intestine
Injection Site Rotation Rotate injection sites to prevent lipodystrophy (fat tissue changes at the injection site)
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