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In particular, incomplete retrieval of grey literature and insufficient documentation of study-exclusion decisions could lead to overestimation of benefits or underdetection of harms, while the infrequent propagation of primary-study bias into meta-analytic models reduces confidence in the magnitude of pooled effects

10.1038/s41467-020-18249-3 [DOI] [PMC free article] [PubMed] [Google Scholar] Zhao X., Wang M., Wen Z., Lu Z., Cui L., Fu C., et al

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This means an expired dose delivers significantly less active drug, reducing your weight loss results and prolonging your treatment timeline