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Spacing meals into smaller portions (rather than three large meals) also reduces the substrate available for bacterial fermentation at any single time
For patients who are not candidates for GLP-1-RAs and have a contraindication to topiramate (e.g., nephrolithiasis) and/or phentermine (e.g., uncontrolled hypertension), monotherapy bupropion or bupropion/naltrexone might be considered, though little data exists regarding its efficacy after bariatric surgery
Both methods share complementary mechanisms that can enhance appetite suppression, improve glycemic control, and promote fat utilization
As of recent, Eli Lilly and Company announced a $1.2 billion dollar investment in a Puerto Rican manufacturing facility to accommodate production of its oral GLP-1 pill and Novo Nordisks engaged in a somewhat unfriendly competition with Pfizer to acquire Metsera
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