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Practical strategies to manage these symptoms include: Eating smaller, more frequent meals rather than large portions, which reduces gastric distension and pressure on the lower oesophageal sphincter Avoiding late-night meals aim to finish eating at least 23 hours before lying down Elevating the head of the bed by 1520 cm to reduce nocturnal reflux Limiting trigger foods such as fatty or fried foods, chocolate, caffeine, alcohol, and spicy dishes Maintaining a healthy weight , as obesity increases intra-abdominal pressure and worsens both hiatal hernia and reflux symptoms Staying upright after meals to facilitate gastric emptying Stopping smoking , as smoking can worsen reflux symptoms Medication optimisation is also important

This can lower the risk of insulin-associated weight gain and may improve patient adherence

But the CagriSema data is important because it proves a principle Ive been applying for decades: MULTI-PATHWAY interventions tend to outperform single-pathway approaches

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