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Patients in Hathaway et al.s study were recruited from a neuro-ophthalmology clinic at a tertiary care institute who very likely have significant underlying symptoms and neuro-ophthalmic diseases that distinctly differ from those of the general population taking GLP-1RAs, potentially causing a selection bias, they wrote

The Tolerability Surprise Conventional wisdom would predict that a triple agonist should be significantly harder to tolerate than a dual agonist

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Your incentive spirometer, if you have one