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For comparison, MassHealth does cover bariatric surgery for patients with BMI over 40 (or BMI over 35 with comorbidities), with approximately 1,200 procedures performed annually at a total cost of $31 million

Whereas changes in dietary patterns and rising rates of obesity and metabolic disease are likely to be contributing factors, increasing exposure to environmental toxins, especially endocrine disruptors, has also been implicated

Common adverse effects include nausea, vomiting, diarrhea, and constipation, which generally improve over time