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The primary risk is rubber particulate introduction from forcing a thin 29-31 gauge needle through a thick rubber stopper, which creates microscopic coring (rubber fragments sheared into the vial)

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However, most effects on body weight are modest and tend to range between 2 to 4% body weight reduction (reviewed in Davidson, GLP-1R agonism in combination with the adjustable gastric band Bariatric surgery is by far the most effective therapy for weight loss reduction and improvements in glucose metabolism (Pories, 2008)