True excess skin does not disappear without surgery
Note that lower doses also tend to produce fewer side effects overall, which is one of the reasons that using a CGM to optimize what the medication is doing metabolically (so you may not need as high a dose for as long) is increasingly being discussed in clinical contexts
This contrasts with controlled animal model findings, which may not accurately reflect real-world complexities
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Surgery: All surgeries come with some risk, although many bariatric procedures are done laparoscopically so they are minimally invasive