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Whether thats a dose issue, a formulation issue, the difficulty of controlling for diet and exercise, or a ceiling on what this mechanism can actually achieve in humans is still somewhat open

The combination produced a mean weight reduction of 20.4% under the treatment-policy estimand, versus 3.0% with placebo (-17.3% difference
Any change in appearance, including crystallization, precipitation, or color change, indicates that the medication should not be used and should be returned to the pharmacy for proper disposal

But for some people, it persists

Disinfect the tops of both vials with alcohol swabs