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Contraindications, intolerable GI effects, cost, or simple preference

Pregnancy and breastfeeding represent absolute contraindications requiring immediate discontinuation regardless of dose

Many patients benefit from ongoing support through registered dietitians, health coaches, or structured weight management programs

During the day, symptoms often occur when holding something for a prolonged period of time with the wrist bent forward or backward, such as when using a phone, driving, or reading a book