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Patients with a history of gastroparesis, severe gastrointestinal disease, or inflammatory bowel disease require careful evaluation, as delayed gastric emptying induced by semaglutide may potentially worsen symptoms or interfere with the absorption of other medications

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1416 Beyond compositional shifts, the functional consequences of dysbiosis are particularly relevant: the microbiota contributes to obesity pathophysiology by driving the production of short-chain fatty acids (SCFAs), modulating bile acid metabolism, and influencing immune and inflammatory pathways