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It might be the benzyl alcohol preservative in bacteriostatic water, which a small percentage of people are sensitive to

Still, for people with copper-metabolism disorders or with repeated/systemic exposure, copper burden is a real theoretical concern that has not been studied in humans

As the studys authors put it, treatment decisions for obesity should be individualised weighed against harms, cost, tolerability and what the patient actually wants, not settled by whichever number is loudest on the label