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465,466 Treatment with tofacitinib has been shown to significantly improve constipation and rectal bleeding

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Treatment protocols typically range from several weeks to a few months, depending on the severity and type of condition being addressed

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Unfortunately for people on a plant-based diet, B12 is difficult to find in animal sources its most abundant in animal products like meat, dairy products, and eggs

Strategies for managing plateaus include: Verify medication adherence and proper injection technique Reassess dietary intake, as reduced appetite may normalize over time Increase structured physical activity with emphasis on resistance training Consider dose optimization if the patient is not yet at the maximum approved dose Evaluate for addition of a complementary medication (phentermine, naltrexone/bupropion, or topiramate) Reframe expectations: weight maintenance at a lower body weight is itself a significant clinical success Clinical Training and Certification The complexity of prescribing incretin-based medications for obesity demands formal clinical education beyond what most providers receive in residency or advanced practice training