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At initial presentation, depigmented white macules were localized on the skin of the periorbital and perioral areas, neck and upper chest, hands, axillae and medial surfaces of the thighs (Figure 1A, 2, 3, 4 and B)

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Combined with adequate protein intake (widely recommended at 1.2-1.6g per kg of body weight during GLP-1 protocols) and resistance training, the higher dose ranges may actually preserve lean mass better than lower doses, because the energy deficit is being met predominantly through fat oxidation rather than muscle catabolism

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