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Onset and progression: Effects are generally progressive, with early appetite suppression occurring within weeks, weight loss accumulating over months, and metabolic improvements continuing with sustained use

Signs and symptoms of low blood sugar may include: dizziness or lightheadedness, blurred vision, anxiety, irritability or mood changes, sweating, slurred speech, hunger, confusion or drowsiness, shakiness, weakness, headache, fast heartbeat, and feeling jittery Kidney problems (kidney failure)

However, the absolute risk remains modest in those without pre-existing gallbladder disease