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Mild elevations in liver enzymes are common with significant weight loss from any cause including bariatric surgery and even intensive dietary programmes

However, this combination also comes with unique considerations and requires close monitoring by healthcare professionals

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Additional factors include autonomic dysregulation, small fiber neuropathy, as well genetic and epigenetic predispositions such as polymorphisms in the catechol-O-methyltransferase well as alterations in pain processing pathways (Siracusa et al

The question, then, is how to support patients in translating that window of opportunity into durable, health-promoting behaviors