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Sleeve gastrectomy physically constrains meal size and triggers mechanical satiety, while semaglutide acts on appetite-regulating neurotransmitter pathways in the central and peripheral nervous system

Patients taking insulin or sulfonylureas with GLP-1 medications should be alert for hypoglycemia symptoms and contact their provider if these occur

Remember, these are general observations based on habits that were consistent

A banana with almond butter or Greek yogurt with berries 6090 minutes before exercise provides sustained carbohydrate energy, protein for muscle support, and natural nutrients without the digestive stress of artificial additives

Protocol amendments This is protocol version 3 dated May 2020