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Adverse events were also registered and reported in RCTs, particularly those more frequently documented (usually with prevalence 5%)

This creates a metabolic environment where weight loss becomes exceptionally difficult and fat storage, particularly visceral fat around the abdomen, becomes the default

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Sleep disorders , particularly obstructive sleep apnea, disrupt metabolic hormones including leptin and ghrelin, potentially reducing medication effectiveness

Abbreviations The following abbreviations are used in this manuscript: Supplementary Materials The supporting information can be downloaded at: Author Contributions Conceptualization, formal analysis, writingoriginal draft preparation, L.X