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The pyridoxine addition provides targeted neurochemical support for exactly these individuals

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Rare but serious risks include pancreatitis and thyroid tumors

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According to NICE guideline NG28, GLP-1 receptor agonists may be considered when triple therapy with metformin and two other oral drugs is not effective, not tolerated or contraindicated, and typically for patients with a BMI 35 kg/m (adjusted for ethnicity) or those for whom weight loss would benefit other significant obesity-related comorbidities