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Meal-induced changes in extracellular 5-HT in medial hypothalamus of lean (Fa/Fa) and obese (fa/fa) Zucker rats

While these effects are widely documented, the study reinforces that they remain the dominant category of reported side effects among users

If meal size, food choices, or hydration are not aligned with this change, nausea and discomfort can occur

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Some individuals escalate dose when weight loss plateaus, then reduce dose once new lower weight stabilizes