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Shamsah Amersi, an OB-GYN who specializes in womens health and metabolic medicine, describes it this way: The body responds to consistency, not intensity. In her practice, she starts patients at 0.05 to 0.1 mg of semaglutide weekly and watches for three things: Appetite changes : Most patients notice subtle but real shifts within two to four weeks

NICE recommends considering procedures such as gastric bypass, sleeve gastrectomy, or adjustable gastric banding for people with: BMI 40 kg/m, or BMI 35 kg/m with comorbidities, or BMI 3034.9 kg/m with recent-onset type 2 diabetes Lower BMI thresholds may apply for people from certain ethnic backgrounds

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