4. Results help us personalize your OPTIFAST program. Its scheduled to run until October 2026. And its a controlled substance. (2021). Your health care provider may suggest a weight-loss drug for you in some cases. If you've lost enough weight to improve your health and you haven't had serious side effects, your health care provider may suggest that you take the drug long term. Eli Lilly, the manufacturer of retatrutide, estimates that the medication may help people lose up to 24% of their initial body weight after 48 weeks (11 months). AskMayoExpert. Fras, J. P., et al. Melmed S, et al. Promote release of glucose-dependent insulinotropic polypeptide which helps modulate levels of a hormone called glucagon and improve insulin sensitivity of adipose (fat) tissue. (2022). Mayo Clinic; 2018. OPTIFAST is a meal replacement program offered through the Duke Lifestyle and Weight Management Center in conjunction with medical, nutritional, and lifestyle support. The total cost depends on the length of your program and how many meal replacement products you consume. 20% OFF Code 20% Off Sitewide Orders Added by Shanna615 Show Coupon Code See Details 1% BACK Online Cash Back 1% Cash Back For Online Purchases Sitewide Verified Get Reward See Details 15% Coskun, T., et al. Sign in to get personalized notifications about your deals, cash back, special offers, and more. 14th ed. Different pharmacies offer different prices for the same medication. If you haven't lost at least 5% of your body weight after taking the full dose of a drug for 3 to 6 months, your health care provider will probably change your treatment. But this is typically managed by slowly increasing your dose over time. But practicing healthy lifestyle habits may help limit weight gain. Compared to phentermine alone, Qsymia can be used for a longer period of time. While results differ for everyone, people who join our three-month program may expect to lose about 10% of their body weight. It accelerates metabolism, which leads to further weight loss, It increases the insulin growth factor (IGF-1), Faster recovery time from strenuous workouts, It reduces fat accumulation in the liver, promoting overall health, Decrease c-reactive protein (inflammatory blood marker. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Biliopancreatic diversion with duodenal switch (BPD/DS), Endoscopic Sleeve Gastroplasty (Gastric Sleeve), Biliopancreatic diversion with duodenal switch. Contrave (bupropion/naltrexone) is another medication used for weight loss. 100% Success. A study of LY3502970 in participants with obesity or overweight with weight-related comorbidities. Santa Fe : (505) 820-7062 Our clinic offers various medications,. Suicidal thoughts and behaviors are another risk listed on the medications labeling because its been reported with other weight loss medications. UP TO 18 MONTHS 0% Interest Financing Available. Several medications are already FDA-approved for weight loss. Used only to treat certain genetic conditions, lowers appetite, increases energy use. Effects of XW003 versus liraglutide on body weight of adult participants with obesity. Lonneman Jr., D. J., et al. This can help make these effects more manageable. Even a modest weight loss of 5% to 10% of your total body weight is likely to produce health benefits, such as improvements in blood pressure, blood cholesterol, and blood sugars. AOD 9604, within itself, stands for Anti Obesity Drug. Another phase 3 trial is expected to wrap up by April 2023. Jastreboff, A. M., et al. | Certified Diabetes Educator, $1,400 to $2,000 plus copays, deductibles, etc. Some restrictions apply and discounts may not be used for online purchases. Led by doctors, nurses, & health experts, not robotic apps, who provide safe, caring, and trusted weight loss guidance. Orlistat can cause side effects such as passing gas and having loose stools. In addition to weight loss, studies show OPTIFAST is safe and can lower blood pressure, total cholesterol, and blood sugar levels. That may not seem like a lot. Wegovy [package insert]. include protected health information. Novo Nordisk; 2022. https://www.wegovy.com. Some people may not be able to reach or tolerate the target dose due to side effects. Center for Medical Weight Loss. In: Williams Textbook of Endocrinology. The standard out-of-pocket cost of Mounjaro without health insurance is $1,516.14 per 4, 0.5ML of 5MG/0.5ML Solution Pen-injector though you can save using a SingleCare Mounjaro coupon to pay only $1,023.95 for 4, 0.5ml of 5mg/0.5ml Pen of Mounjaro. Or maybe its related to a health issue your provider warned you about. As mentioned above, GLP-1 agonists, like semaglutide, were originally used to treat Type 2 diabetes. All at incredible savings! Compare prices and information on the most popular Weight Loss medications. (2022). The Mayo Clinic Diet is designed to help you lose up to 6 to 10 pounds (2.7 to 4.5 kilograms) during the initial two-week phase. The FDA has approved setmelanotide only for people age 6 and older who have obesity due to one of these rare inherited conditions: To take the drug, you'll need to have test results that show you have one of these conditions. Doctors Weight Loss Coupon, Promo Codes: 20% Off - April 2023 Doctors Weight Loss Coupons & Promo Codes Submit a Coupon Save with 12 Doctors Weight Loss Offers. This content does not have an Arabic version. U.S. Food and Drug Administration. One-on-one support tailored to you.We offer comprehensive customized, non-surgical weight loss programs utilizing the right combination of clinical and lifestyle support to fit your personal needs. FDA approves new drug treatment for chronic weight management, first since 2014. These sessions give you the opportunity to talk about what to eat and when, whats working, any challenges, lifestyle changes, and how we can help you reach your weight loss goals. Our healthy and delicious recipes will keep you motivated and on track with your weight loss. 87% Off. Weight Loss Clinics in Murrieta | Tri Valley Medical Weight Control Spring into Shape Call: 951-461-0540 WEEKLY WEIGHT LOSS PROGRAM Starting At Only $30 FAST AND AFFORDABLE MEDICAL WEIGHT LOSS PROGRAMS NO APPOINTMENT NECESSARY. Not to be combined with any other offers or promotions. As mentioned above, semaglutide mimics GLP-1. Sign up to receive more information about the services and programs atthe Duke Lifestyle and Weight Management Center. AOD 9604 has recently found fame for its natural ability to help you burn fat and increase your weight loss results. Center for Medical Weight Loss. The food gives you a total of about 800 to 1000 calories per day and all the daily recommended nutrients you need to stay healthy while you lose weight. They may switch you to a different weight-loss drug. Oral weight loss medications tend to be less expensive than the injectable options, but you may not lose as much weight. They help lower your blood sugar by triggering insulin release and blocking sugar production. Unless your insurance policy covers weight-loss drugs, you'll have to look for ways to avoid paying for them out of your own pocket. At the three subsequent weekly visits, clients progress and diet protocol are evaluated, vitals and precise measurements are taken, personalized care and adjustments are made, and that weeks supply of appetite suppressants and B12 injection are provided by patient-dedicated staff. You can unsubscribe at any time. By providing your email address, you agree to receive emails containing coupons, refill reminders and promotional messages from GoodRx. After about 6 months, people receiving mazdutide lost about 8% to 13% more of their body weight than those given the placebo. We also work with people whose BMI is slightly lower and have conditions such as prediabetes, diabetes, sleep apnea, joint pain, or liver disease. The medical staff gave me the positive reinforcement weekly at the free check-ups that I was craving. ARD-101 is a twice-daily oral pill. (2014). Trademarks, brands, logos, and copyrights are the property of their respective owners. Toward the end of the program (week 10 for our 12-week option and week 18 for the 24-week option), youll receive resources and expert guidance to help you transition back to regular foods. That's why it's important to ask your health care provider about all treatment choices. But Wegovys active ingredient, semaglutide, only targets GLP-1 receptors, not GIP receptors. (2022). GoodRx works to make its website accessible to all, including those with disabilities. Tirzepatide once weekly for the treatment of obesity. Another potential interaction is with oral medications. Like semaglutide, it mimics GLP-1. Nutritionally balanced diet protocol and dedicated coaches aim to help patients maintain a targeted healthy weight. No problem! Liraglutide also is used to manage diabetes. Many of these medications have risks and side effects to keep in mind. You willeagerly find that AOD 9604attacks the hard-to-lose areas, as well as the areas where your body accumulates the most fat. Mayo Clinic. GoodRx provides no warranty for any information. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. (2022). Rhythm Pharmaceuticals; 2022. https://www.imcivree.com. Merchant is solely responsible to purchasers for the care and quality of the advertised goods and services. Not much is known about how it works. It was originally approved in 2017 at a lower dose under the brand name Ozempic to help control blood sugar in Type 2 diabetes. Innovent Biologics. Medical Weight Loss Clinic is a leader in the weight loss industry, with 29 clinics throughout Michigan and Ohio. Your progress is always monitored for safety and success. Yes, there are many medications that are prescribed off-label for weight loss. Our team of medical advisors and weight loss clinicians is led by Dr. Spencer Nadolsky, a lipid specialist certified with the American Board of Obesity Medicine. ClinicalTrials.gov. information and will only use or disclose that information as set forth in our notice of (2022). Whats more, the initial data appears positive. Lose up to 20% of your total body weight in 4 months. $40 . Its a GLP-1 agonist thats thought to be a longer-lasting alternative to medications like liraglutide. Join us at any of our upcoming events and be inspired when you meet some of our Honored Champions. It can be used by adults with a body mass index (BMI) greater than or equal to 30 mg/kg alone or 27 mg/kg with at least one weight-related condition (e.g., high blood pressure, high cholesterol, Type 2 diabetes). I would also like to sign up for a free GoodRx account, Written by Julie Adkison, PharmD, BCACP, CDCES. Many of these medications have risks and side effects to keep in mind. 2019; doi:10.1016/j.metabol.2018.10.010. Patients must come in weekly to complete the program. Once-weekly semaglutide in adults with overweight or obesity. It can be used in different ways, such as fat reduction, skin rejuvenation, cellulite elimination and sculpting fat. There is a problem with By signing up, I agree to GoodRx's Terms and Privacy Policy, and to receive marketing messages from GoodRx. Your actual weight loss will be determined by many factors, including, but not limited to: your medical circumstances, the plan you choose, adherence to the meal plan and use of nutritional supplements. 8% Off Medical Supplies. MWL Seattle, WA, 901 Boren Avenue Suite 1900, Seattle, WA 98104. Its phase 2 trial was expected to conclude by November 2022, but results arent available yet. Whats more, a phase 3 study for weight loss recently began in China. Las Cruces : (505) 888-9575 Proprotein subtilisin-kexin type 1 deficiency, Swollen or irritated skin where the needle went in. Compared to other medications on the market, it may help you lose more weight. You also can get orlistat in a reduced-strength form without a prescription (Alli). Rio Rancho : (505) 896-4737 Vivus LLC. (2022). These include if you haven't been able to lose weight through diet and exercise and your: Before choosing a medicine for you, your health care provider thinks about your history and health challenges. $100 Off Options Medical Weightloss Coupon (2 Promo Codes) Jan '23' $100 Off Competitor Discount Codes: Get Up To $100 Off With These Options Medical Weightloss Competitor Coupons for Wellness Apps & Services (January 2023) See Competitor Codes 45 competitor promo codes - Last used 1h ago 5% Off Amazon Pick It affects the way your body absorbs fat. $226 for Four-Week Weight-Loss Program from Transformations Medical Weight Loss ($459 Value) 4.7 1,298 Groupon Ratings One 4-week medically supervised weight loss program for new patients only 5,000+ bought $459 $226 51% Off Over 30 views today, so act now! GoodRx works to make its website accessible to all, including those with disabilities. If you carry your weight in the mid-section and back areas, this is a great peptide that can assist you in receiving the results you want. Promotional value expires 90 days after purchase. Body mass index (BMI) is greater than 30. (2017). Rarely, serious side effects can happen. Limit one per client. Enjoy Enhanced Fat burner Injections, GLP-1 medications, Take home boosters, B12 for extra energy and better digestion, and top it off with 2 Liquid Lipolysis treatments! Metabolism. Lets schedule a telemedicine appointment and get you started! THE PATIENT AND ANY OTHER PERSON RESPONSIBLE FOR PAYMENT HAS A RIGHT TO REFUSE TO PAY, CANCEL PAYMENT, OR BE REIMBURSED FOR PAYMENT FOR ANY OTHER SERVICE, EXAMINATION, OR TREATMENT THAT IS PERFORMED AS A RESULT OF AND WITHIN 72 HOURS OF RESPONDING TO THE ADVERTISEMENT FOR THE FREE, DISCOUNTED FEE, OR REDUCED FEE SERVICE, EXAMINATION, OR TREATMENT. This is higher than we tend to see with other weight loss medications. It can lessen your appetite and make you feel fuller. Novo Nordisk files for US FDA regulatory approval of once-weekly semaglutide 2.4 mg for weight management. 586 were here. This helps you eat less and feel full for longer. Avoid injecting the medication into the same spot every time change your injection site with each dose. Interim results from a phase 2 study comparing ecnoglutide to liraglutide found that, after about 4 months, ecnoglutide helped people lose slightly more weight. Temporarily changing your exercise routine will help us better monitor changes to your body and how youre feeling. In addition to the above list, there are a few notable medications to keep in mind that are currently being studied as weight loss treatments: Orforglipron: Also being developed by Eli Lilly, orforglipron (LY3502970) is an oral medication that mimics GLP-1. Phentermine hydrochloride [package insert]. These low-carb, high-protein meal replacements will help you Keep-It-Off and live healthy! Insurance Coverage and Health Spending Accounts Options include: Using a GoodRx coupon for a discount on the retail price. If this is the case, your healthcare provider may wait another month before increasing your dose. Scottsdale 480-922-1222 8114 E. Cactus Rd Suite 230 Scottsdale, AZ 85260 Located on the corner of Cactus & Hayden Peoria 623-412-2700 7972 W. Thunderbird Rd Suite 106 Peoria, AZ 85381 Minnesota Maple Grove 763-494-4300 7967 Wedgewood Lane Maple Grove, MN 55369 Corner of Wedgewood and Elm Creek Blvd National 1-866-996-LOSE (5673) Dont live in a state where Medshape is located? The best weight loss drug for you depends on your preferences, body weight goals, and medical history. Just know that you need to use prescription weight-loss drugs in addition to not instead of a healthy diet and exercise. This content does not have an English version. Each product costs about $3 to $5. This is especially the case before and during treatment to ensure that your readings stay within a safe range. Additional common side effects can include: In some cases, semaglutide may cause more serious side effects. Still, some internal or external factors may be driving you to try to lower your body weight. This package includes all of MedShapes most popular products and medications. A consultation in a MEdShape medical facility is required. In one study, participants lost an average of 15% to 20% of their initial body weight. 500 Benson Road, Garner 4.9 mi. Medication for weight management is an effective component in losing and keeping off weight, but only when complemented by appropriate dietary choices and exercise. To provide you with the most relevant and helpful information, and understand which Mazdutide (IBI362) is a once-weekly, under-the-skin injection. Obesity (adult). Prescription drugs are medicines that a health care provider prescribes for you. GLP-1 is an incretin hormone that plays a role in your appetite and digestion. (2013). If injections arent for you, an oral version of ecnoglutide is currently being studied in a phase 1 trial. With age, this is diminished. Keep It Off Medical Weight Loss' New Direction Meal Replacements provide you with convenient, great-tasting nutrition. (2015). Tirzepatide was compared to semaglutide in a head-to-head clinical trial in people with Type 2 diabetes. For example, it can lower blood pressure, blood sugar levels and levels of fats in the blood called triglycerides. CODE. 2023 guidance call. Individuals results vary. Adolescent clinical trials showed an average weight loss of 16%. An Investment in Your Health Pays a Lifetime of Dividends Medshape Weight Loss Clinic is one of the most affordable, comprehensive weight control programs available today. They also slow down how quickly food leaves your stomach (called gastric emptying). Semaglutide (Wegovy) is the first once-weekly medication in its class thats FDA-approved to help with chronic weight management. Its thought to lower your appetite by mimicking the gut hormone pancreatic peptide YY (PYY). View all locations below, see clinic hours and schedule an initial weight loss consultation at a time that works for you. Over the same length of time in another study, adolescents lost 16% of their initial body weight on average. While tirzepatide isnt currently approved for weight loss, promising results from a phase 3 trial for this use were published in July 2022. WITH B12 THE HOTTEST MEDICATION AVAILABLE FOR WEIGHT LOSS, Now Available through MedShape Weight Loss Clinic. Wilding, J. P. H., et al. It has also been shown to provide an average weight loss of about 8% from baseline body weight. Three ways to purchase a special Call your nearestMedShapeWeight Loss Clinic and schedule an appointment or place an order over the phone, or purchase online through our store. Weight loss with naltrexone SR/bupropion SR combination therapy as an adjunct to behavior modification: The COR-BMOD trial. Weekly Weight Loss Program - Only $31.95! Now, youll enjoy a streamlined experience created specifically for healthcare providers. Nausea is a common complaint. Most people think that being at a healthy weight means being "thin." Actually, a healthy weight is a weight that lowers your risk for health problems. If you have trouble logging in, have questions about how to use Duke MyChart, need more information about Phentermine is a popular oral weight loss medication that has been around since 1959. Common side effects include nausea, headache and constipation. ClinicalTrials.gov. Phentermine by itself (Adipex-P, Lomaira) also is used for weight loss. Weight Loss Deals: 50 to 90% off deals in Weight Loss near you. Wadden, T. A., et al. We serve patients across the country. Mayo Clinic; 2018. CONTRAVE is a prescription weight-loss medicine that may help some adults with a body mass index (BMI) of 30 kg/m 2 or greater (obese), or adults with a BMI of 27 kg/m 2 or greater (overweight) with at least one weight-related medical problem such as high blood pressure, high cholesterol, or type 2 diabetes, lose weight and keep the weight off. Patient assistance programs ( if you're uninsured or underinsured ). Promo Code . There are ways to save on semaglutide, which is available as brand-name Wegovy. First time purchase only, local category deals. OPTIFAST is not a diet for healthy people who want to lose a few pounds. The most aggressive way to kickstart your weight loss journey and sculpt your trouble areas. They may lessen over time. Accessed Oct. 12, 2020. For example, a copay savings card can help make your prescription more affordable. (2018). But current evidence suggests that oral semaglutide may offer more weight loss benefits than medications like liraglutide. your account, or need to contact customer service, please, Find an OPTIFAST Weight Loss Program Doctor, Copyright 2004-2023 Duke University Health System, Duke Lifestyle and Weight Management Center, This page was medically reviewed on 07/08/2022 by, Lifestyle and Weight Management for Adults, Medical Weight Loss for Children and Teens, Fundamentals of Medical Weight Management, Fundamentals of Medical Weight Management FAQ, Sign Up for Lifestyle and Weight Management Information, weight loss and healthy lifestyle programs, Elisabetta Politi, CDCES, MPH, RD Shah, M., et al. GoodRx is not sponsored by or affiliated with any of the third-party brands identified. Semaglutide is an FDA-approved injectable weight loss medication. A phase 3 study is on deck for 2023. information submitted for this request. But sometimes a medication may be added to help you reach your goals. It was more effective for long-term blood sugar control, and people taking it lost more weight compared to semaglutide. Typically, we tend to see an average of 5% to 10% weight loss with other medications. We at FIT Medical Weight Loss Clinics firmly believe that our physician supervised weight loss and weight management programs change lives. A study of IBI362 evaluating weight loss in obese and overweight Chinese subjects. A 2017 study found that among 136 marketplace health insurance plans, 11% of plans covering nine states had some coverage for drugs to treat obesity. Since semaglutide slows down how quickly food leaves your stomach, you may experience side effects like nausea and vomiting. No problem! CagriSema is a combination treatment that combines two injectable medications (cagrilintide and semaglutide) into one therapy. So, its only given once a week. Review/update the Ozempic (semaglutide) Pramlintide (Symlin) Topiramate (Topamax) Bupropion (Wellbutrin SR, Wellbutrin XL) Zonisamide (Zonegran) Note: You should never take medication for weight loss purposes without talking to your healthcare provider first. (2022). If youre taking one of these medications, your healthcare provider may lower the other medications dose while starting you on semaglutide. Youll learn strategies and tips for managing your weight for life. We have more than 25 convenient Medical Weight Loss Clinic locations in Michigan and Ohio. How MedShape Is Different: When you adhere to the program, we guarantee your weight loss results! Ends 4/9. Mayo Clinic does not endorse companies or products. Like tirzepatide, it mimics GIP and GLP-1. Tirzepatide works in a way thats comparable to Wegovy, an injectable medication thats currently approved for weight loss. Liraglutide (Saxenda), a once-daily injectable GLP-1 agonist, was the first medication in its class to be approved for weight loss. YES, I Want to Speak with a Counselor to Learn More, Yes, I want to Schedule a Phone Consultation, YES, I would like to Schedule a Phone Consultation, READ MORE ABOUT TIRZEPATIDE (Generic Mounjaro) HERE, YES, I WANT TO SCHEDULE A PHONE CONSULTATION, Purchase the Full Body Makeover Package HERE. Setmelanotide doesn't treat any of the gene problems that cause these conditions. New England Journal of Medicine. As your program progresses, the rate you lose weight may change and you will have the opportunity to discuss this at every daily visit with your weight loss consultant, where changes to your meal plan and/or program can be made. New patient? It has been used 353 times. $65. The other drugs in this group aren't often prescribed. It reduces body fat, Increases fat metabolism, Prevents excess food to turn into fat, and it works as a skin tighter. Weight management (adult). Buy Now Add to Cart Give as a Gift Share This Deal Highlights After completion of the program, you can also continue counseling with our medical, nutrition, or behavioral health providers to help with long-term weight management. Study to evaluate ARD-101 in adults with obesity. Your initial comprehensive evaluation will include a physical exam and blood tests. We celebrate each milestone with you to help you stay motivated. Sign up for our GoodRx Diet and Nutrition Newsletter to receive the latest healthy eating advice, recipes, and savings that are most relevant to you. Nabilone: Currently approved as an anti-nausea medication, this cannabis cousin is enrolled in a phase 2 weight loss trial that should be completed by May 2023. $175 3-Months Medical Weight Loss Program Includes: Doctors visits, Monthly b-12 injections, Appetite suppressant Rx (Adipex or Phentermine), Diet and Exercise Counseling, Measurement log, Lipo Fat Burner (Only $10 upgrade) We offer a full line of pharmaceutical grade supplements, such as Slimdown and Raspberry Ketones. Bupropion-naltrexone can raise blood pressure. Not to be combined with any other offers or promotions. Acts as Gastric Bypass feeling as slowing down the digestive process no room to eat and curbs hunger. information highlighted below and resubmit the form. Taking tirzepatide for weight loss is discussed in detail in this recent GoodRx Health article. We are a Doctor supervised weight loss program. The coach explores each participant's challenges with losing weight, including diet knowledge, lifestyle and eating habits, to help set up Transformations diet protocol. Tesamorelin may be the Right Peptide for you! Semaglutide is typically injected just under the skin (subcutaneously) in your abdomen, upper arm, or thigh. This was due to their blood sugar-lowering effects. ClinicalTrials.gov. show Get the skinny on this fat-fighting, shrinking, body changer! Its a GLP-1 agonist, similar to Wegovy and Saxenda. (2022). Semaglutide is available as a single-use injection pen. If you have commercial insurance, you may be eligible to pay as little as $25 for Wegovy using a savings card from the manufacturer. (2022). Initial medication-assisted weight loss help clients begin shedding pounds, while recipes and food knowledge help educate patients for long-term results. New England Journal of Medicine. (2022). Pharmacological management of obesity: An Endocrine Society clinical practice guideline. Youll work with our weight management specialists to determine which plan meets your needs. Our telemedicine program can establish you as a patient with one of our practitioners and get you started (depending on your location). Lose Weight and look better, younger and leaner. (888) 492-1326 2252.59 mile. It's given as a daily shot. As your program progresses, the rate you lose weight may change and you will have the opportunity to discuss this at every daily visit with your weight loss consultant, where changes to your meal plan and/or program can be made. In participants with obesity those with disabilities same medication gas and having loose stools body fat, and copyrights the! Compare prices and information on the market, it can lower blood pressure, total cholesterol, and works... Offers, and copyrights are the property of their body weight on average tirzepatide works in reduced-strength... 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Agree to receive more information medical weight loss coupons the services and programs atthe Duke lifestyle and weight specialists! Loss Clinic a skin tighter personalized notifications about your deals, cash back, special offers and. People with Type 2 diabetes all treatment choices turn into fat, increases metabolism. Another phase 3 trial for this request down the digestive process no room to and. Weight on average conditions, lowers appetite, increases fat metabolism, Prevents excess to. Like liraglutide skinny on this fat-fighting, shrinking, body changer programs atthe Duke and! This fat-fighting, shrinking, body weight in 4 MONTHS orlistat in a phase 3 for. Your email address, you agree to receive emails containing coupons, reminders. Results from a phase 3 trial is expected to conclude by November 2022, but may... Prescription ( Alli ) n't often prescribed called gastric emptying ) lower other... 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