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The pharmacological options were embarrassing: a few stimulants with edges sharp enough that most physicians refused to prescribe them, a couple of lipase inhibitors with a side-effect profile so gruesome it functioned as accidental aversion therapy, and a small number of older drugs that had to be repurposed off-label

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The SURMOUNT-4 trial followed participants for up to 88 weeks and confirmed that the overall safety profile remained consistent with earlier phases, with gastrointestinal events continuing to be mild to moderate and manageable throughout

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