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Weight loss typically begins within the first four to eight weeks and continues steadily as the dose is titrated to therapeutic levels

For example, FTO carriers may benefit from structured meal timing and higher protein to overcome genetic appetite bias, while others show stronger response to lower-carb approaches

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The start low and go slow dosage changes are frustrating, but will reduce the risk of semaglutide fatigue

Nevertheless, observational studies such as these cannot determine whether low levels of vitamin B12 were the cause of the weight gain or whether higher levels of vitamin B12 protected against lower levels