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And perhaps most relevant to this combination, hunger hormones, particularly ghrelin, tend to decrease in ketosis, reinforcing the appetite suppression that semaglutide is already creating through a completely separate pathway

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There are several reasons people might want to switch: Weight loss plateaus after a few months on semaglutide Gastrointestinal side effects like nausea or constipation that are not manageable Desire for better glucose control Personal goals (e.g., prefer faster weight loss progress ) In my practice, the most common reasons I recommend patients to switch medication is 1) they are having uncomfortable or unmanageable side effects from semaglutide including heart burn, nausea, constipation or 2) their weight loss starts to plateau before they reach their weight loss goals

However, a sudden, drastic increase in fiber can sometimes lead to bloating and gas, so a gradual approach is key

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