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These findings suggest that the microbiota-modulating effect of BD is primarily attributable to DHP (233)

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I don't necessarily see it as an 'either/or' situation

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It happens because weight loss affects fat throughout the body, skin may not tighten fast enough after rapid loss, and some muscle can be lost without strength training

Combining both medications addresses blood sugar control from multiple angles metformin reduces liver glucose production while Ozempic promotes insulin secretion and suppresses appetite