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[42] pooled 31 long-duration RCTs (84,713 participants) of GLP-1 RAs in diabetes and obesity, populations again largely free of significant psychiatric comorbidity, and found no increase in depression, anxiety, or suicidality, providing robust evidence for psychiatric safety in large, controlled settings

Critical for motivation

Skipping this step doesn't just reduce comfort - it significantly cuts how much medication actually enters your bloodstream, which directly reduces results