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And as you said, further lifestyle and other elements can down-regulate enzyme activity even further

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Cell Rep 13:968980 Feng H, Liu XH, Wang S, Fleming J, Wang DC, Liu W (2017) The mechanism of ndm-1-catalyzed carbapenem hydrolysis is distinct from that of penicillin or cephalosporin hydrolysis

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For best results, pair appetite regulation with a structured plan that includes adequate protein, high-fiber foods, hydration, and resistance training to help preserve lean mass during weight loss

We'd also encourage you to chat with your doctor about the options available, so they can help you make the best decision for your situation