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For adults over 40, the maintenance phase is not a passive thing it requires conscious decisions about whether to stay on a maintenance dose, taper down, or come off entirely

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Stress management Chronic stress contributes to elevated cortisol levels, which may encourage abdominal fat accumulation in susceptible individuals

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The tradeoffs are equally real: weekly injection, $900+ per month without insurance, limited supply relative to demand, and side effects that affect a substantial portion of users nausea, vomiting, constipation, and GI disruption are among the most common, particularly during dose escalation