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Thats not only because some patients dont respond well to the treatment but also because the drug should be avoided altogether (or at least used with extreme caution) in some cases

The gut lining is significantly damaged

kefiri to a low-calorie diet increased weight loss and further improved the glycemic and lipid profile and also caused a further improvement in obesity-associated dysbiosis, mainly by increasing the muconutritive and regulatory (e.g., Bifidobacterium spp., Akkermansia muciniphila ) microbiome, and decreasing the Firmicutes / Bacteroidetes ratio ( Bifidobacterium spp