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Without structured resistance training, increased protein intake, and body composition monitoring, patients may lose not just fat but vital skeletal muscle and bone, undermining long-term health outcomes

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But most haven't been well studied for efficacy and safety in humans, so taking them is a gamble

The default protocol around them is

Association of obesity with bone mineral density and osteoporosis in adults: a systematic review and meta-analysis

Hunger changes happen at different stages during the treatment