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This effect also reduces cravings

The body usually adapts over time

In addition, adipose tissue secretes proinflammatory cytokines, including tumor necrosis factor- (TNF-) and interleukin-6 (IL-6), which may impair neuromuscular control and exacerbate nocturnal respiratory instability (9, 10)

This start-low,-go-slow approach balances efficacy with minimised GI side effects and improves adherence during the transition period

Cumpston M, Li T, Page MJ, Chandler J, Welch VA, Higgins JP, et al

It is therefore not surprising that inflammatory infiltrates have been documented in diabetic patients in the esophagus, supporting the concept of diffuse gastrointestinal involvement within diabetic autonomic neuropathy rather than isolated gastric disease