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The goal of medically supervised weight management is not simply to tolerate a prescription at any cost

That's potentially 37 to 50 pounds for someone weighing 250 pounds

If you are already keto-adapted and adding GLP-1, the transition is somewhat easier because you have already navigated keto adaptation

For health professionals, understanding the range of strategies patients are exploring, as well as the evidence (or lack thereof) behind them, is vital to guiding safe and effective care

Flat sleeping removes this advantage entirely and allows stomach acid a clear, level path upward

That said, here is how we think about it in practice