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Other gastrointestinal effects during week one may include: Constipation or diarrhoea bowel habit changes affect roughly 1020% of patients Reduced appetite often marked and may feel unusual initially Indigestion or acid reflux particularly when lying down after eating Fatigue or mild headache possibly related to dietary changes or adjustment period Injection site reactions such as redness, itching, or mild swelling may occur but are generally minor and resolve quickly