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The nutritional breakdown of Citrucel varies depending on the product (2): Citrucel contains a different type of fiber than many other popular fiber supplements

The dose is often increased gradually to help reduce stomach side effects

Hassan C, Antonelli G, Dumonceau JM, Regula J, Bretthauer M, Chaussade S et al (2020) Post-polypectomy colonoscopy surveillance: European Society of Gastrointestinal Endoscopy (ESGE) Guideline Update 2020

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The buccal fat pads, temples, and periorbital regions deflate, creating the "gaunt" look