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older adults most vulnerable Weight regain: average 9.69 kg after stopping, mostly fat Nutritional deficiencies: protein, B12, and micronutrients What this means clinically: Screen for eating disorder history before prescribing Monitor for anhedonia, mood changes, and restrictive eating patterns Order baseline and repeat ferritin, B12, and vitamin D Prescribe resistance training and protein targets alongside the medication Monitor body composition, not just weight Have the length of treatment and cessation conversation at initiation We are iterating in real time on a drug class taken by tens of millions of people