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The authors discuss how the synergistic mechanisms of the two drugs lead to superior weight loss and cardiometabolic improvements, positioning the combination as a significant advance in the treatment of obesity and type 2 diabetes

The key steps are: Identify the gastro-esophageal junction as at the tops of the gastric mucosal folds If hiatus hernia is present, do not mistake the diaphragmatic hiatal impression for the gastro-esophageal junction For circumferential columnar-appearing mucosa above the gastro-esophageal junction define this extent in centimetres above the gastro- esophageal junction: report as the C value For any tongue-like areas of columnar-appearing mucosa, measure the Maximum extent in centimetres above the gastro-esophageal junction: report as the M value The IWGCO has produced a DVD which presents background to the C&M Criteria, including an annotated video clip that explains the Criteria, and endoscopic video clips designed to build experience in the use of the Criteria

In a meta-analysis in 2006 Kal et al

PubMed 3

Start with the simpler protocol and escalate only if your skin handles it without irritation, dryness, or the adverse reactions some users experience

There is no universal schedule