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Illustrator patterns create very complex vectors. Unlike images, they cannot be compressed.
However, there you can sometimes remove some size in the PDF using Acrobat Pro's Optimizer feature. Sometimes Illustrator data that is not needed in the PDF can be removed. In Acrobat XI, that is File > Save As Other > Optimized PDF. You can use the Audit Usage to view where the PDF size comes from (which requires some experience to utilize). In the Discard User Data on the left, check Discard hidden data of other applications, and resave the PDF file.
Thanks for the answer. I'll just tried running Audit Usage, and ~35% of my document is "Overhead". I'm assuming that can be deleted in some way?
It may be able to be deleted as I described above.
Ah yes, sorry. You already answered that one. :-)
I'll fiddle around with the settings a bit and see if I can hit a home-run.