Orlistat, phentermine/topiramate, naltrexone/bupropion, and the incretin-based drugs liraglutide and semaglutide, both GLP-1 receptor agonists (GLP-1RA), and tirzepatide, a biased dual GIP/GLP-1 receptor agonist, are currently both FDA and EMA approved for the management of non-syndromic obesity 10
The result is dramatically improved survival through gastric transit
much lower at community doses Vomiting up to 36% at high doses Diarrhea 23-26% Constipation 17-19% Fatigue 11-13% Pancreatitis risk trials flagged severe abdominal pain for discontinuation and evaluation Gallbladder issues rapid weight loss increases gallstone risk Thyroid C-cell tumors same boxed warning as semaglutide (animal studies) GI side effects were more intense than semaglutide in trial data due to the dual mechanism
People get vitamin B12 primarily from animal products, including eggs, meat, dairy products, and fish, so a balanced diet can easily achieve the needed levels of this nutrient
This helps counteract diabetes-related vascular dysfunction, which is a key driver of kidney decline
However, after taking time to think about the differences in our respective situations, I have arrived at a rather different conclusion