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Other effects include: Fatigue and dizziness , particularly during the initial weeks Headache , usually mild and self-limiting Increased heart rate , typically a modest elevation Hair thinning , which may occur with rapid weight loss from any cause (telogen effluvium) rather than as a direct effect of the medication [14] Rare but serious side effects include pancreatitis (severe, persistent abdominal pain radiating to the back), thyroid C-cell tumours (shown in rodent studies