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When people lose significant weight through calorie restriction alone, metabolic adaptation kicks in, reducing resting energy expenditure by 15 to 20 percent more than would be predicted by the change in body mass alone
Clinically, such hemolytic episodes are characterized by anemia and jaundice accompanied by increased concentrations of bilirubin and LDH in plasma and reticuloytosis
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Conversely, the appetite-suppressive effects may be more sustained in lower-estrogen states, potentially offering therapeutic advantage in weight management
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