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This discrepancy between formal trial data and patient-reported experiences may reflect several factors: cold sensitivity might not have been specifically monitored in trials, it may be attributed to weight loss rather than the medication, or it might affect only a subset of patients

has been critical of the drug as a weight loss method, saying that it focuses on symptoms of obesity rather than fixing what he classifies as root problems, such as food systems and exercise

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Gastroenterology 131 , 15531560 (2006)

Their structural origin is different