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Its particularly well suited for those who want to avoid pharmaceuticals, those who have tried GLP-1 drugs and experienced unwanted side effects, and those who want to address root causes as part of a broader wellness strategy

This leads to significant weight reduction in people with obesity

Together, they can discuss the benefits and drawbacks of stopping the medication on an individual basis, as well as the importance of committing to long-term lifestyle changes, such as diet and exercise, to manage weight

Unrealistic expectations can lead to disappointment with in-office procedures

The mechanisms of action of GLP-1 (reviewed extensively by Doyle and Egan, 2007) go beyond just the augmentation of glucose-induced insulin secretion and include increasing insulin expression (Drucker et al ., 1987), inhibiting beta-cell apoptosis and promoting beta-cell neogenesis (Perfetti and Hui, 2004

Still, this new work with cryo-EM technology may serve us as a reminder, albeit indirect, that not paying full attention to adverse effects of undetected and unmanaged hyperinsulinism, the first dimension of insulin dysregulation, leaves much to be desired