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"The issue is that the skin does not always adapt to this reduction, particularly if there was pre-existing laxity or poor muscle tone

2006 Aug;291(2):E381-7

In accordance with NICE guidance , management of restless legs syndrome involves identifying and treating underlying causes, addressing lifestyle factors, and considering specific treatments if symptoms are moderate to severe and significantly impact quality of life

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Additionally, obesity itself is a known risk factor for GERD due to increased intra-abdominal pressure, so some patients may notice improvement in baseline reflux symptoms as they lose weight despite the medication's initial effects

[ref] Nitric Oxide Connection Endothelial nitric oxide is a gas produced by the endothelial cells that line blood vessels