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It is knowing which patient needs a GLP-1 and which one needs a workup, how to titrate through the nausea window without losing the patient, how to protect lean mass during rapid loss, how to screen for the contraindications that matter, and how to tell a patient honestly what an adjunct will and will not do for them

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Loss of muscle is a concern with low calorie dieting such as The Omaha Weight Loss Diet and GLP-1 agonist use

For those without a B12 deficiency, shots are unlikely to provide additional health benefits