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With consistent use and medical support, many see 1520% reductions in total body weight over several months

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Now they are taking 0.5 mg, double their intended dose

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Their appetite suppression effects can be risky for adolescents who need extra nourishment during puberty and older adults who might already have diminished appetites

But caloric restriction, combined with the reduced nutrient density of a smaller total food volume, creates conditions where B vitamins including B12 become limiting factors for mitochondrial energy production