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Nonetheless, reduced side effects at lower doses make it likely there are also reduced therapeutic effects

Right now, only about 80,00090,000 people (diabetic and obese) are on weight-loss drugs

Dietary and lifestyle modifications are typically the first-line approach: Eat smaller, more frequent meals rather than large portions Avoid lying down for at least two to three hours after eating Elevate the head of the bed by 1520 cm if nocturnal symptoms are present Reduce or avoid known reflux triggers such as fatty or spicy foods, caffeine, alcohol, and carbonated drinks Maintain a healthy weight, as excess abdominal weight increases intra-abdominal pressure Pharmacological management may also be appropriate in some cases

Corticosteroids promote: Fat redistribution , causing central (truncal) obesity and the characteristic "cushingoid" appearance with prolonged use Fluid retention , leading to weight gain that may not reflect true fat accumulation but can be discouraging Muscle protein breakdown , reducing lean body mass and potentially lowering metabolic rate Insulin resistance , making weight loss more difficult The magnitude of these effects is generally dose- and duration-dependent

Moreover, lithium can act as an anti-oxidant by increasing the CHS levels in neurons of rat dopaminergic N27 95,99