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All analyses were performed using Stata (v16.1, StataCorp LLC)

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Pre-existing GERD combined with semaglutide creates a compounding effect that requires more aggressive intervention than either condition alone

Standard dose: 5001000 mg per day Intense training or definition phase: up to 2000 mg per day (divided into two doses) Cycle duration: 48 weeks, extendable if necessary It is recommended not to exceed 2000 mg per day

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