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Research shows the delay is most pronounced during the first 1 to 2 hours after a meal, which is why many people notice their worst reflux symptoms shortly after eating rather than on an empty stomach

Metalloproteinase-9/tissue inhibitor of metalloproteinase-1 in induced sputum in patients with asthma and chronic obstructive pulmonary disease and their relationship to airway inflammation and airflow limitation

Furthermore, if you have a slow metabolism, this can lead to weight gain and fatigue

This is done because the vial is a vacuum, and you need to add an equal amount of air to regulate the pressure, making it easier to draw the medication into the syringe