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Others improve the vascular component by supporting nitric oxide production and smooth muscle relaxation

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For patients with severe obesity (BMI 40 kg/m or 35 kg/m with comorbidities) who have not achieved adequate weight loss with non-surgical interventions, bariatric surgery may be considered following specialist assessment, as outlined in NICE CG189

Incorporating a balanced diet and regular, low-impact physical activity can also support the overall effectiveness of this treatment