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[8] [9] The risk of low blood sugar increases meaningfully only when these agents are combined with insulin or sulfonylureas

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The STEP 4 trial, which specifically examined semaglutide withdrawal, showed that participants who stopped the medication regained 6.9% of body weight over 48 weeks, while those who continued treatment lost an additional 7.9%

contraindicated in patients with personal/family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 Risk of diabetic retinopathy complications in patients with pre-existing retinopathy Potential for acute kidney injury, particularly related to dehydration Caution or avoidance in severe gastroparesis or severe gastrointestinal disease Suicidality warning for weight-management indications (Wegovy, Saxenda) Potential for altered absorption of oral medications due to delayed gastric emptying In older adults with cognitive impairment, medication adherence may be challenging, and gastrointestinal side effects could lead to dehydration or nutritional deficiencies

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