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Exclusion criteria included pregnancy, lactation, recent abdominal surgery, structural abnormalities, a history of organic diseases, severe metabolic disorders, or GI-related drugs

Physically, crash diets can result in extreme fatigue, inability to exercise, and a weakening of immune function, she says

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The study concludes that PEM is key to diagnosis and believe graded exercise therapy and cognitive behavioural therapy have been reported to be safe and effective

To understand why this combination exists, you need to understand what each component does on its own