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A number of phenotypic elements should be carefully assessed, including neurological and cognitive symptoms (such as impairment of concentration and short-term memory, perceptual and sensory disturbances, sensory and emotional overload phenomena), autonomic manifestations (such as orthostatic intolerance, palpitations, gastro-intestinal symptoms), neuroendocrine manifestations (such as loss of thermostatic stability, intolerances of extremes of heat and cold, worsening symptoms with stress), and immune manifestations (such as tender lymph nodes, recurrent sore throat or flu-like symptoms, general malaise (flu-like feelings of being ill and feverish)

Some patients report improved mood and energy alongside weight loss particularly patients for whom compulsive eating, low motivation, and depression were intertwined

The changes are being challenged by medical organisations, including the American Academy of Paediatrics (AAP), in a lawsuit

Severe allergic reactions: Includes itching/swelling, rash, and anaphylaxis, a life-threatening reaction that requires immediate medical attention

Table IV