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In developed countries, situations at greatest risk for deficiency include eating a diet restricted in fruits and vegetables, smoking or long-term exposure to secondhand smoke, and drug and alcohol abuse

In real-world practice, side effects loom even larger patients may not have close monitoring or reassurance, and frequently self-discontinue when persistent nausea or other issues make them feel worse before they feel better

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GLP-1 therapies have demonstrated substantial weight-reduction benefits, with studies showing an average weight loss of 4.6 kg, a BMI reduction of 2.1 kg/m, and a decrease in waist circumference of 4.6 cm compared to placebo

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