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From a methodological standpoint, most analyses demonstrated moderate risk of bias with sound statistical adjustment (IPW, matching, multiple imputation) but limited causal inference due to observational design

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Lang PA, Schenck M, Nicolay JP, Becker JU, Kempe DS, Lupescu A, et al

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While most patients adapt within 36 months, some experience diarrhea that continues or emerges after a full year of treatment

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These intensive dietary interventions can help counteract the metabolic adaptations and appetite increases that follow cessation

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