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Not every patient achieves the weight loss targets they are hoping for, and a meaningful proportion of patients even on maximum doses do not reach the 1520% body weight reduction that clinical guidelines increasingly use as a benchmark for meaningful metabolic benefit

PubMed 11121901..

2017 Sep-Oct;35 Suppl 107(5):40-46

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They become hyper-reactive, firing off inflammatory chemicals in response to minor triggers like foods, temperature changes, or stress