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Despite treatment, the woman is unable to verbalize or care for herself, requiring an ongoing feeding tube for nutritional support.

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Clinical observations describing reduced protein intake, variability in lean mass trajectories, and micronutrient insufficiency during pharmacologically induced weight loss [40, 75, 94, 95] suggest that long-term metabolic stability may become sensitive to substrate availability even in the absence of overt deficiency

In 2022, Lu et al