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Whilst no direct causal link has been established in clinical trials, several physiological mechanisms related to the medication's effectsincluding metabolic changes from weight loss, altered digestion, and dietary modificationsmay theoretically explain these anecdotal observations

Patients with pre-existing constipation, those taking other medications that slow gut motility (such as opioids or anticholinergics), and individuals with inadequate fluid or fiber intake face elevated risk

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