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You mentioned Stanford has a Department of Metabolic Psychiatry

Bariatric surgery continues to be the most effective modality for weight loss and metabolic improvement in patients with obesity [19]

A 2020 meta-analysis of 37 trials found L-carnitine supplementation reduced body weight by 1.21 kg, BMI, and fat mass, especially at 2,000 mg daily, when combined with diet and exercise

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Clinical trials show that some patients experience mild to moderate blood pressure reduction, though severe hypotension remains uncommon when treatment is properly monitored