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While some receptor adaptation does occur (explaining why gastric emptying effects attenuate over time even as doses increase), the central appetite-suppressing effects appear to be maintained through mechanisms that do not rely solely on gastric motility

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It does not protect against sexually transmitted infections (STIs) and is less effective than other birth control methods when used repeatedly

Increased heart rate a dose-dependent rise of about 5 to 10 beats per minutewas also seen, peaking around week 24 and declining afterward