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For others, the safer first step may be labs, lifestyle counseling, treatment of sleep apnea, medication review, or addressing a medical driver of weight gain

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doi: 10.1111/j.1365-2982.2009.01430.x 126 KodaSDateYMurakamiNShimbaraTHanadaTToshinaiKet al

Likely drivers of increased circulating 5-HT are increased density or glucose-sensitivity of duodenal EC cells, as evidenced in obese human duodenal EC cells (38), however molecular mechanisms underlying this are not understood