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Foods to avoid include high-fat foods that do not contain fiber such as butter, processed foods like chips and donuts, fruit juices such as orange juice, and other foods high in sugar like cookies, cakes, and sugar-sweetened yogurt

The recommended injection sites include the abdomen, thigh, and upper arm, rotating them with each dose to prevent pain, bruising, and skin thickening

Document the dates, side effects, and lack of results for each

Three things happen: gastric acid production drops dramatically, intrinsic factor production declines because most parietal cells are in the bypassed stomach, and food no longer passes through the duodenum, where the transfer to this carrier normally occurs