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You might notice slightly reduced appetite suppression on days 9 through 11, and some people report mild mood fluctuations as drug levels dip below their usual trough

The standard starting dose is typically 2.5 mg weekly for the first 4 weeks, which is then gradually increased to minimize side effects

The same study also showed significant reductions in cognitive deficit and dementia risk

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It's important to note that weight loss itself is an evidence-based therapy for GERD, so the weight reduction achieved with these medications may actually improve reflux symptoms in some patients, potentially offsetting any direct effects on the gastroesophageal junction