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Contrave works in the brains hypothalamus to reduce hunger, and in the mesolimbic reward system in the brain, to reduce food cravings

Metopimazine is a dopamine D2 receptor antagonist that exerts its antiemetic effects via the chemoreceptor trigger zone, which mediates nausea and vomiting through peripheral receptors

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If there is a disproportionate loss of muscle mass, then it can create other health issues for already vulnerable groups, like older adults and people with sarcopenia (low muscle mass and impaired physical function)