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10.1016/j.atherosclerosis.2011.06.048 15 DyallJ.ColemanC

While it's much hardier, we still strongly recommend refrigeration for optimal preservation

They did note a mild rise in gallstone disease (OR 1.30, p = 0.041)

The program may not be the right fit for anyone who requires in-person clinical evaluation, anyone outside the eligible state list, anyone uncomfortable with the non-refundable consultation policy, or anyone whose medical history may be excluded under the published criteria

Self-pay ~$149/month

And there is one truth none of us can avoid: diet is the major driver of weight gain