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Rats receiving vagotomy do not reduce food intake in response to peripherally injected GLP-1 indicating that vagal afferent nerves are needed to relay peripheral GLP-1 signals to higher brain regions to regulate feeding (Abbott et al., 2011)

This can be OK for some people who may respond well and not need a more potent drug, or those with less body fat to lose

This worldwide escalation in population BMI is associated with multiple comorbidities and is believed to have numerous causes, including dietary habits, lifestyle, environmental stimuli, genetic predisposition, endocrinological disruptions, and gut dysbiosis [15,16]

We don't expect our patients to become 100% keto, or paleo, or any of the extremes

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