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As the medication begins to reduce appetite, patients should focus on structured meal planning that includes adequate protein, fibre, and healthy fats, as recommended in the NHS Eatwell Guide
This requires eliminating all sources of wheat, barley, rye, and cross-contaminated oats (certified gluten-free oats may be tolerated by most patients)
In normal circumstances, this takes five months, but sometimes patients repeat a month or go slower per doctors instructions on individual tolerance
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Some protocols use doses up to 250 mcg, but starting low is advisable
