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Results vary based on: Starting weight Metabolic factors Consistency with treatment Most are mild and temporary: Nausea (usually subsides in weeks) Constipation Headaches Severe side effects are rare but include pancreatitis or gallbladder issues

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All patients were required to have continuous enrollment of at least 12 months before cohort entry and meet eligibility criteria for one of the five cohort studies defined below (study design diagrams depicted in Supplementary Figs

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