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Patients who titrate too quickly may feel nauseous and reduce food intake unsustainably, while those who titrate too slowly may miss the medication's peak appetite-suppressing window

Cell Metab (2012) 16:296309

However, the finding was considered secondary to the reduction of blood pressure rather than a direct effect of the drug on the RAAS

Styrkarsdottir U, Thorleifsson G, Sulem P, Gudbjartsson DF, Sigurdsson A, Jonasdottir A, Jonasdottir A, Oddsson A, Helgason A, Magnusson OT, Walters GB, Frigge ML, Helgadottir HT, Johannsdottir H, Bergsteinsdottir K, Ogmundsdottir MH, Center JR, Nguyen TV, Eisman JA, Christiansen C, Steingrimsson E, Jonasson JG, Tryggvadottir L, Eyjolfsson GI, Theodors A, Jonsson T, Ingvarsson T, Olafsson I, Rafnar T, Kong A, Sigurdsson G, Masson G, Thorsteinsdottir U, Stefansson K (2013) Nonsense mutation in the LGR4 gene is associated with several human diseases and other traits

If those benefits prove durable, Bellomo noted that mortality improvements would likely arise primarily through reductions in cardiovascular disease, with smaller contributions from other obesity-related conditions

Diagnostic imaging and testing , including endoscopy reports, gastric-emptying studies, and lab data showing nutritional deficits or electrolyte abnormalities