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[4] Has not been studied in combination with insulin

While this does not provide permanent protection against weight regain if dietary habits completely revert, it does mean that keto-adapted people who maintain even moderate carbohydrate restriction after stopping semaglutide can often maintain significantly more of their weight loss than those who have no dietary strategy at all

However, some factors are worth considering

Loot MAM, Kenter SB, Au FL, van Galen WJM, Middelkoop E, Bos JD, et al

A decrease in vitamin B12 and/or folate results in an increase in homocysteine level