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Cohen's d = 1.03

A series of clinical trials known as the STEP clinical trials demonstrated that almost 90% of patients lost 5% or more of their body weight

Renal protection has also been documented, with trials demonstrating reduced progression of diabetic kidney disease

This discrepancy in clinical recommendations underscores the critical need for comprehensive real-world evidence studies to elucidate the safety profile and adverse reaction patterns associated with combination therapy

However, these associations likely reflect underlying disease processes rather than B12 toxicity itselfelevated B12 is often a marker of serious illness rather than its cause

Clinical trials demonstrate an average body weight reduction of 14.9% over 68 weeks, and many patients experience rapid, visible results within the first few months of treatment