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Potential downsides include a slower onset of significant weight loss compared to tirzepatide and gastrointestinal side effects, particularly nausea during the first month, that can be challenging when you are already dealing with fatigue and disrupted eating patterns

Use recent records: stale weights or old labs can trigger delays Match the diagnosis to the request: coding and chart wording should point in the same direction Document failed or insufficient response clearly: vague phrases like tried diet dont help much Prepare for renewal early: if ongoing treatment later requires proof of response, your follow-up notes should already capture progress A good file doesnt exaggerate

J Hepatol 2023;79:842-852

This field provides mechanistic insight into why individuals exhibit different metabolic outcomes in response to identical dietary patterns

doi: 10.1139/o71-037 10 BrownJCMuttVPedersonRA