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Red flags requiring immediate attention include: Unexplained weight gain while on semaglutide Severe or persistent gastrointestinal symptoms Signs of pancreatitis (severe abdominal pain radiating to the back) Symptoms of gallbladder disease (right upper quadrant pain, fever, jaundice) Signs of dehydration or kidney problems (decreased urination, dizziness) Hypoglycemia symptoms if taking insulin or sulfonylureas Depression or suicidal thoughts Symptoms of thyroid problems (neck mass, difficulty swallowing, persistent hoarseness) Pregnancy or planning pregnancy (semaglutide should be discontinued at least 2 months before a planned pregnancy) These situations require prompt medical evaluation rather than waiting for a routine follow-up appointment