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All thirteen studies found an effect of ES on at least one behavioral domain and will be described below

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Important safety considerations include contraindications in patients with personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2, caution in those with a history of pancreatitis, increased risk of gallbladder disease, potential for acute kidney injury with dehydration, and possible worsening of diabetic retinopathy with rapid glycemic improvement

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