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This is consistent with the broader principle that obesity behaves as a chronic, relapsing disease rather than a problem solved by a single brief course a theme that runs through every medication in this class

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Factors such as daily dosing schedules, strict timing requirements, side effect tolerance, and long-term adherence can influence whether patients remain on treatment long enough to see meaningful results

For example, the Rotterdam criteria permit a phenotype defined by ovulatory dysfunction and PCOM in the absence of hyperandrogenism, whereas the NIH criteria require hyperandrogenism together with ovulatory dysfunction