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Insulin resistance, chronic stress, poor sleep, and certain medications (antidepressants, antipsychotics, corticosteroids) can counteract appetite suppression

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He explains that amount of enlargement of the left atrium (mild, moderate, or severe enlargement) usually correlates with the degree of mitral regurgitation -- mild, moderate, or severe MR -- which is the most important factor in determining when to begin treating MVD prior to heart failure