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Consider: Dietary protein review Resistance training encouragement Body composition assessment where available (DEXA or bioimpedance) Functional strength measures Rapid weight loss without protein adequacy may increase lean tissue loss

Pharmacol Ther 207:107464 Takahara M, Takaki A, Hiraoka S, Takei K, Yasutomi E, Igawa S et al (2022) Metformin ameliorates chronic colitis in a mouse model by regulating interferon--producing lamina propria CD4+ T cells through AMPK activation

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In clinical studies, a combination containing piperine demonstrated its potential role in supporting the gut-hormone pathway that regulates appetite and glucose metabolism