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[DOI] [PMC free article] [PubMed] [Google Scholar] 132.Onoue S., Ohshima K., Debari K., Koh K., Shioda S., Iwasa S., Kashimoto K., Yajima T

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KEY TAKEAWAYS Insulin resistance can be tested through fasting insulin and glucose ratios, even in countries where insulin testing is less common Rapid weight loss rates above 15% annually may indicate no need for dose increases Severe GI side effects warrant investigation beyond medication adjustment, including gallbladder evaluation DEXA scans provide valuable visceral fat measurements, but results should be interpreted alongside overall health markers Maintenance strategies should focus on nutritional stability before considering medication tapering NOTABLE QUOTE "It's not that the medicine causes the rebound weight gain, it's that with the medication in there, the body is getting better signals, and then you go and take the medication away and you're in the same boat." Dr

Clinical decisions should be individualized based on patient preferences, comorbidities, medication regimens, and treatment goals, with ongoing medical supervision to monitor safety and efficacy