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If you dont notice a reduction in hunger immediately, it doesnt mean the medication isnt working

Evidence shows that the secretion of incretin hormones may be impaired in some patients (particularly secretion of GLP-1 in obese individuals), but the major responsible factor is a loss of beta cell responsiveness to the incretin hormones [4]

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[1] [2] The mechanism behind this nausea involves several physiological pathways

chest discomfort accompanied by shortness of breath, sweating, nausea, or lightheadedness