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I have been tracking my own body composition with DEXA scans since 2017

Management strategies: Eat smaller, more frequent meals Avoid high-fat, greasy, or heavily spiced foods initially Stay hydrated For constipation (common): increase fiber gradually, drink more water, consider magnesium supplement Ginger or peppermint tea for nausea Dont lie down immediately after eating (helps with reflux) Under-eating risk (serious for women over 40): The appetite suppression can be so strong that some women struggle to eat enough protein and calories to support muscle maintenance and basic metabolic function

These are not small losses

Akkermanisa Muciniphila is a type of beneficial bacteria that comprises up to 4% of the gut microbiome in healthy people