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Commonly Reported Effects Include: Mild nausea or stomach upset Slight muscle cramping in rare cases A temporary fishy body odor (due to metabolite trimethylamine) To minimize discomfort, always begin with a lower dosage and increase gradually as your body adapts

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To view digital features for this article go to Introduction Obesity (defined as a body mass index [BMI] 30 kg/m 2 in adults [1]) is a major health concern in the USA [2] and is associated with multiple complications, including cardiovascular disease, type 2 diabetes, and osteoarthritis [3,4,5,6,7,8]