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These reductions in fat mass, lean body mass, and muscle mass correlate with the degree of body weight reduction and are similar to those documented with other obesity therapies that achieve large weight reductions, such as bariatric surgery and very low-calorie restricted diets [61]

The development of obesity is affected by the quantity and quality of muscle mass and its metabolic rate (in other words, the energy burned at rest to keep a system going)

Patients experiencing persistent systemic symptoms should be evaluated for other causes, including intercurrent illness or dehydration

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In the case of chronic liver failure, protein metabolism is greatly altered and numerous complications can occur (decreased albumin, ascites, and increased risk of hepatic encephalopathy)