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There are definitely assumptions in this paper, including that an average weight gain shifts the whole distribution of the populations weight in a way that bumps many people into the higher-BMI categories, Courtemanche acknowledged in an interview

And yet she is uncommonly self-possessed, perfectly at ease being messy for the collective gaze of millions

As a result, clearance of the concomitantly administered agent(s) may be inhibited or otherwise delayed, which could lead to an increase in their serum concentrations, increasing the risk and/or severity of adverse reactions associated with exposure to such drugs (DrugBank, 2024b)