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This orexigenic drive appears to be largely GH-independent, as it is observed even in models of GH-deficiency, and is accompanied by rises in leptin that likely reflect expansion of adipose depots and provide a feedback brake on further hyperphagia
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When that pathway is suddenly dampened, patients may feel: Less pleasure from eating Emotional blunting Frustration or irritability This is not the same as depression, but it can feel unsettling if not anticipated
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(d) an ice pack is helpful at the injection site if local reactions occur like edema
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