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He called Zappy "the biggest victims of this situation" and said that it has left the company in "severe financial and reputational ruin." Some Zappy customers NPR spoke with found out about the problem on Reddit

Appetite suppression begins, but weight loss may be modest as dosing is gradually increased to minimize side effects

After that, a doctor may increase the dose depending on blood sugar response and tolerability

GLP-1 and dual agonists: Insulin needs can fall quickly (often around 30% early on), and bolus timing may need adjustment due to slower gastric emptying