If it is real hunger, it comes with other physical signs, like a growling stomach, low energy, or feeling shaky, says Herberto Valdes, MD, an endocrinologist at Baptist Health South Florida in Pinecrest and Miami
These include stress, poor sleep, intense exercise, low-calorie diets, and existing medical conditions like PCOS or thyroid disease
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Patients often report that the appetite-suppressing effect of semaglutide makes dietary changes easier to sustain, amplifying the metabolic benefits of metformin's insulin-sensitizing action