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Theyre influenced by very real, very identifiable variables: Neurotransmitter balance, particularly dopamine signaling Hormonal status and age-related changes affecting CNS response Metabolic adaptation, including muscle mass and basal metabolic shifts Psychiatric history, where closer monitoring is appropriate Population-level data does not indicate increased suicidal ideation risk overall, but individualized care remains essential

doi: 10.3390/medicina58101377 95 HuangJTaoCYuYYuFZhangHGaoJet al

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There are people who sustain significant weight loss through huge amounts of effort and personal discipline