Clinically, severity often rises with dose or with overlapping risks like: Obesity Certain foods Late-night meals The practical point is this is a mechanical effect, not a mystery: change the timing or volume of whats in the stomach, and you change the odds of reflux
This effect is independent of when you last atethe peptide works on basal gastric motility, not meal-triggered responses
DOI: Jose, J., Al-Tamimi, F
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Berenbergs steady rating also hints this is a slow demand shift, not a near-term shock