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Researchers who lifted weights throughout treatment maintain significantly more muscle mass, creating more aesthetic proportions and better metabolic health
While prescription weight loss medications have been on the market for decades, such as phentermine, the newer GLP-1s, including Ozempic (used off-label for weight loss) and Wegovy, have been generally shown to be more effective than previous treatments
Any benefits, such as improved energy or clearer skin, are typically gradual and may take several weeks or even months of consistent use to become noticeable
A reasonable transition approach is to move from strict keto (under 25 grams net carbs) to a low-carbohydrate diet (50 to 100 grams net carbs) that is less restrictive but still meaningfully below the carbohydrate intake that drove the original weight gain
Notably, low vitamin B12 status is also a risk factor for NTDs (71), further suggesting that homocysteine toxicity may be a factor in their pathogenesis
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