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CLINICAL BOX 25-1: CARNITINE-RELATED ABNORMALITIES Deficiencies in carnitine and the activity of the carnitine palmitoyltransferases lead to impaired energy production from fatty acid oxidation

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Harshal Kirane, medical director of Wellbridge Addiction Treatment and Research

In simple terms: fiber helps you: Feel full on fewer calories Keep digestion moving (important if GLP-1s slow gastric emptying) Stabilize blood sugar and energy levels Examples of high fiber low carb foods These high fiber low carb foods pair nicely with GLP-1 support: Non-starchy vegetables: Broccoli, asparagus, spinach, kale, cabbage, green beans, zucchini Low-sugar fruits (small portions): Berries, kiwi, citrus, sliced apple or pear with skin Legumes (moderate carbs but high fiber + protein): Lentils, chickpeas, black beans Seeds & nuts (portion-controlled): Chia, flax, pumpkin seeds, almonds, walnuts Whole grains in small portions: Quinoa, oats, barley, especially helpful if youre active A growing body of research suggests that fiber intake is one of the strongest predictors of long-term weight-loss success and dietary adherence , even after accounting for total calories (Miketinas et al., 2019)

3 in the non-GLP-1 RA group

While the overall risk of adverse events such as bleeding or infection is relatively low, careful attention to indications remains essential