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Alternatively, some patients benefit from pancreatic enzyme supplements (such as lipase and amylase) that improve carbohydrate digestion before fermentation occurs in the stomach

Pancreatitis and Kidney Issues: There have been concerns about an increased risk of pancreatitis and potential kidney problems, especially in those with a history of these conditions

Vitam Horm (2022) 118:45778

You also want to use stress-reduction techniques as needed

A comparative study of obese and lean rats found that lean rats showed greater drops in estrogen and vitamin D and higher urinary calcium excretion after weight loss, suggesting increased sensitivity to calcium disturbances

Optional calorie boosts let you adjust upward on days when appetite allows