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It slows down gastric emptying (the speed at which food leaves your stomach) and signals the brain that you are satisfied with smaller amounts of food

doi: 10.1016/j.pcd.2017.06.005

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In the current study, the distribution of bioavailabilities was appropriately described with a log-normal distribution and the upper percentiles were substantially lower than 100%, despite the log-normal distribution theoretically having no upper end

I think the evidence is regardless of impact on HRV, these drugs are beneficial on a longevity basis - but if having side effects, adjust things and go to another drug