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Genetics may play a small part in this

So if you're shrinking the size of your stomach with bariatric surgery, it doesn't really address that

In Studies 2, 3, 5, 7, 8 and 9, all patients received instruction for a reduced-calorie diet (approximately 500 kcal/day deficit) and increased physical activity counseling (recommended to a minimum of 150 min/week) that began with the first dose of study medication or placebo and continued throughout the trial