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A vitamin B12 deficiency is common among many Americans, even more so in those that adhere to a vegan or vegetarian diet

At baseline and at weeks 8 and 12, a clinician should assess fasting insulin and HOMA-IR (the homeostasis model assessment of insulin resistance, a calculated index derived from fasting glucose and insulin), HbA1c, high-sensitivity C-reactive protein as an inflammatory marker, and body composition by DEXA scan or bioelectrical impedance

Here is a critical point that trips people up

It can only be billed once per visit

This is particularly powerful for patients who are overweight and experiencing severe trouble losing weight with other interventions