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Semaglutide has robust randomized trial evidence and an FDA weight loss indication

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The gap in efficacy between Tirzepatide and Retatrutide, approximately 3-4 percentage points of body weight at comparable doses, is real but smaller than the gap between Semaglutide and Tirzepatide

B12 injections can help with:1

It is discussed but not clear if this variation of fat and lactose content during one feeding has an effect on hunger and satiety regulation

Getting B12 into the nervous system quickly helps prevent permanent nerve damage [3] [4]