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The study published in the JAMA Network Open cited cost as the likely reason, with side effects also mentioned
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Glucagon-like peptide 1 and its analogs act in the dorsal raphe and modulate central serotonin to reduce appetite and body weight
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The former reflects a proportional decrease in lean tissue during negative energy balance and is typically expected to account for roughly one-quarter of the total weight loss, whereas the latter involves both quantitative loss of skeletal muscle and impaired muscle function or strength [19]
