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Semaglutide significantly increased diuresis and natriuresis in Glp1r VSM+/+ mice, whereas the diuretic effect was blunted and natriuresis absent in Glp1r VSM/ mice (Figure 4, GI)

At day 85 (approximately 12 weeks), patients in the low-dose group lost an average of 7.19 percent of their body weight and the high-dose group lost an average of 14.52 percent of their body weight, while the placebo group gained an average of 1.49 percent of their body weight

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So the goal isn't "as cold as possible." The goal is cool and steady, ideally in that fridge-like 36 to 46 degree range, without ever touching ice

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Pancreatitis Inflammation of the pancreas