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For example, people who maintain a vegetarian or vegan diet, people with absorption disorders, and those taking prescription meds like Metformin, Proton Pump Inhibitors (PPIs), and H2 blockers like Pepcid are often at greater risk

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By comparison, the DPP-4 inhibitors, saxagliptin and alogliptin, carry a regulatory warning about the finding of an increased risk of hospitalization for heart failure in treated patients enrolled in large-scale trials carried out with these drugs [57]

It is important to note that these metabolic adaptations are generally physiological responses to weight loss rather than pathological changes