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When ketosis is added to semaglutide treatment, the theoretical and observed weight loss rate tends to increase because both approaches are simultaneously reducing caloric intake through appetite suppression, shifting metabolism toward fat oxidation, and improving insulin sensitivity

Notably, co-administration with farnesoid X receptor (FXR) agonists or peroxisome proliferator-activated receptor (PPAR) agonists may enhance lipid metabolism regulation and anti-inflammatory effects, addressing multiple pathogenic pathways simultaneously

Rather than aiming for individuals to commit to complete abstinence, these medications may allow for meaningful reductions in alcohol consumption, decreasing both the intensity and frequency of heavy drinking episodes

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Renal function should be monitored in patients with renal impairment or when experiencing severe gastrointestinal adverse effects that could lead to dehydration and acute kidney injury

What made things worse were the night-time hunger pangs