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Significant and measurable weight loss is usually seen after a few months of consistent use, with the most substantial results becoming apparent over a period of 6 months to a year

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For each of our outcomes of interest, a repeated measure within-between interaction was performed with a group, time (i.e., pre/post), and group by time interaction as the explanatory variables and a random effect for the individual was performed using the lme4 package 51

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Dehydration becomes the primary medical concern, as fluid loss combined with reduced oral intake can lower blood sodium and potassium levels within hours