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The absence of a preexisting obesity diagnosis or any previous anti-obesity drug further acted as surrogate markers for potential off-label prescribing of the GLP-1 RA brand with the indication of obesity

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Rather than mixing the powder into a large glass of water and swallowing it immediately, the manufacturer and functional medicine practitioners recommend placing the powder directly in the mouth (or mixing it with a tiny sip of water) and holding it under the tongue or against the cheeks for 30 to 90 seconds before swallowing

Ihedioha et al., 2020