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These are not secondary curiosities for patients with obesity who also live with hypertension, dyslipidaemia, or elevated inflammatory markers, systemic risk reduction may be as clinically important as the weight loss itself

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It has also been reported that peripherally produced leptin can bind to leptin receptors that are expressed in ependymal cells, crossing the ependymal barrier

More expensive programmes add clinical reviews and support from a registered dietitian or coach