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In particular, patients with PWS presented a chronic imbalance between higher energy intake, due to hyperphagia [9], and lower total and resting energy expenditure measured by indirect calorimetry when compared with subjects with age-, sex-, and BMI-matched controls [6]

People over 65 or those with lower BMI (27-30 range) may want to consider a more conservative titration schedule, staying at each dose for 6 weeks instead of 4, and possibly targeting 8mg as the maintenance dose rather than pushing to 12mg

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