If something hurt you before, you are expecting that same level of pain, even though this time it may not be as bad, which is why like, yeah, like to your point, if someone is giving you an injection and you look away, the pain is less because you are not getting that visual input that's dialing up the pain

The combination is most useful for patients with one or more of the following: BMI of 30 or higher , or BMI 27 with at least one weight-related condition such as type 2 diabetes, hypertension, or sleep apnea History of fatigue, low mood, or brain fog on previous diets or weight loss attempts Metformin use for type 2 diabetes or pre-diabetes (chronic metformin reduces B12) Long-term proton pump inhibitor use such as omeprazole, pantoprazole, or lansoprazole Vegetarian or vegan diet with limited animal protein intake Adults over 50 , where B12 absorption naturally declines Active strength training or higher physical demands while on a calorie deficit Patients who dont fit any of these profiles can still take semaglutide alone, then add B12 if symptoms suggest it
New targeted therapies are being explored, including inhibitors specific for Kit-ligand, hepatocyte growth factor, or the MET signalling pathway
Prussick reports no relevant conflicts of interest