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All patients underwent comprehensive preoperative psychological evaluation by a pediatric psychologist to assess readiness, compliance, and presence of eating disorders or untreated mood disturbances
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[28] Studies examining weight loss interventions in lymphoedema populations have reported potential benefits, including reduced limb circumference and improved mobility in some patients
But it is not the only outcome, and in patients with established atherosclerotic disease or heart failure, it may not even be the primary mechanism of benefit
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