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Environmental Toxins Smoking disrupts blood flow, overstimulates the HPA axis, and raises cortisol, increasing blood glucose and inflammation
Hutch CR, Sandoval D (2017) The role of GLP-1 in the metabolic success of bariatric surgery
(Even prior to this use, doctors could prescribe the diabetes versions drug off label for weight loss.) I wrote about this more here
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Options at that point may include switching medications, adding adjunctive therapy, investigating underlying conditions like hypothyroidism or PCOS, or reassessing whether this medication class is right for you
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