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First, homocysteine (Hcy) is quite a bit lower in females than in males

It may be necessary to schedule meals or use liquid nutrition to get enough calories, even when not hungry

Safety Research Priorities Comprehensive long-term safety studies are critically needed, particularly given concerns about potential effects on cancer development and progression

Published 2011 Jun 7

For adults with a BMI of 40 kg/m2 or higher or those with a BMI of 35 kg/m2 or higher with obstructive sleep apnea or prediabetes, Apovian recommends strongly considering bariatric surgery as a first-line therapy due to very low complication rates and robust and durable weight loss