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However, their efficacy is driven primarily by appetite suppression rather than sustained increases in energy expenditure, and adult human physiology imposes a clear ceiling on thermogenic contributions

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Therefore, monitoring cardiovascular risk factors starting as early as during adolescence is essential, evaluating at least annually electrocardiogram, lipid, and pressure profile, carrying out second level investigations, such as cardiac ultrasound, 24 h ambulatory blood pressure monitoring, or inducible myocardial ischemia test when necessary [33, 34]

doi: 10.1038/nrn.2016.178