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Jian, H

Patients lacking intrinsic factor, those with gastrointestinal surgery, or severe neurological symptoms benefit most from injections

Let's look at what the science suggests is happening behind the scenes

Complementary approaches may include: Behavioral therapy or weight management counseling Sleep optimization (79 hours nightly) Stress management techniques Evaluation and treatment of coexisting conditions (insulin resistance, sleep apnea, depression) FDA-approved oral weight loss medications (orlistat, phentermine/topiramate ER, naltrexone/bupropion) as alternatives to injectables (note: phentermine monotherapy is approved for short-term use only) Patients should maintain realistic expectationsweight loss may be slower with hypothyroidism, even when well-controlled

M.KanneD