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For obesity without binge eating, the primary dysfunction appears to be impaired GLP-1 action, characterized by reduced satiety signaling and relatively rapid gastric emptying
The most effective step is choosing lower-mercury seafood and limiting high-mercury fish such as shark, swordfish, king mackerel, and large tuna, especially during pregnancy
This might include: Non-pharmacological strategies : Heat or cold application, gentle exercise, physiotherapy, and relaxation techniques Topical preparations : NSAIDs gels or creams for localised musculoskeletal pain Graduated pharmacological approach : Starting with paracetamol and escalating only if inadequate Specialist referral : For persistent or severe pain requiring assessment by pain management services Patients should maintain open communication with their diabetes care team about any additional medications they are taking, as this enables comprehensive medication review and optimisation of their overall treatment plan
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