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These high costs, lower adherence in practice, and frequent weight regain after discontinuation, each highlight the importance of complementary nutritional and lifestyle counseling to help maximize overall efficacy and cost-effectiveness [84]

Your appetite is regulated by a sophisticated hormonal system that evolved to protect you from starvation, and when that system is disrupted by obesity, hormonal imbalance, or chronic calorie restriction, the experience of hunger becomes genuinely harder to manage than it is for people whose systems are working normally

Diabet Med 2008;25:4504

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