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Excess cortisol breaks down muscle tissue, causes severe water retention, disrupts deep sleep, and tells your body to aggressively store fatspecifically stubborn visceral belly fat

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[5] [6] Gallbladder disease : Rapid weight loss associated with this drug class may increase the risk of cholelithiasis (gallstones) and related biliary complications

The powder is relatively cheap, so its not a big add on cost wise