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Semaglutide and tirzepatide work primarily through central nervous system mechanisms: appetite suppression in the hypothalamus, modification of food reward signaling in the brainstem, slowed gastric emptying that prolongs satiety

Sustained therapy is generally needed to keep results

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Once testing reveals positive anti-intrinsic factor antibodies or other confirmatory markers, coders should update to the appropriate specific code-most often D51.0 for pernicious anemia

When clinically appropriate, B12 supplementation may be recommended as part of a medical evaluation