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Factors that may contribute to taste alterations include: Gastrointestinal side effects : Nausea, reflux, and belching can leave a bitter or sour taste Dehydration : Reduced fluid intake or increased losses may affect saliva production and taste Dietary changes : Weight loss regimens often involve significant dietary modifications Metabolic changes : Ketosis from caloric restriction can produce a metallic taste Most gastrointestinal side effects of Zepbound tend to diminish over time, typically improving after the first few weeks of treatment or following dose escalation