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doi: 10.1016/j.gene.2019.144045 70 ZhouH.Lin-WangK.WangF

GLP-1 medications can cause fatigue through several mechanisms including reduced caloric intake due to appetite suppression, gastrointestinal side effects leading to dehydration and electrolyte imbalances, and metabolic adjustment to improved blood glucose control

PMID 24552327

E for Evolving Perhaps the most important factor is change

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