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This can lead to changes in appetite and, indirectly, weight gain

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It should not be used by people with a history of pancreatitis, medullary thyroid cancer, or diabetic retinopathy (a diabetes-related eye disease that damages the blood vessels in the retina)

Alcohol is often combined with sugary mixers, significantly increasing the calorie intake

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In those situations, lowering the dose may temporarily reduce symptoms, but it does not address the underlying sleep disruption that is contributing to the problem