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Most of the reproductive benefits observed in the trials are likely indirect mediated through weight loss and metabolic improvement rather than a direct drug effect on reproductive biology

Nature 398 , 828832 (1999)

Clinicians and patients should interpret early reports with appropriate caution and recognize the distinction between hypothesis-generating observations and proven therapeutic interventions

[32] This restrictive procedure reduces stomach capacity, limits food intake, and alters gut hormone productionparticularly ghrelin, the 'hunger hormone'