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"There's a windfall." Elyassnia said he's had patients return for more surgery after going on the medications, because they appear deflated after losing weight quickly and "the face takes the brunt of that." When it comes to the body, some opt for lifts and tucks to remove excess skin, while others choose fat transfers to restore lost volume

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Since the treatment algorithm put forth by the ADA says always start with metformin first, some professionals and people with diabetes are asking, why start with metformin and not with one or both of these two classes of medications

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