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Thats because it can take a long time to build up to a high enough dose where patients lose weight

Nature 1986

Avoid Cold Turkey: Simply quitting cold turkey often leads to a rapid return of intense hunger and cravings

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Extending that fast further by skipping breakfast, especially on a drug that enhances insulin sensitivity, is asking for a headache

Metrics of sleep apnea severity: beyond the apnea-hypopnea index