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Because every barrier to enrollment is another reason someone might turn to an unsafe alternative

MitchellELDavisATBrassKDendingerMBarnerRGharaibehRet al

I., Hjelle, B

Activating it tells the brain you're full, slows digestion, and reduces how much you want to eat

10.1016/j.pbi.2006.05.014 Curr

Post-cholecystectomy patients with certain genetic profiles may experience more pronounced gastrointestinal side effects or nutrient absorption challenges, supporting a case for more conservative dose titration or closer monitoring