This multi-pronged approach explains the unprecedented 24.2% weight loss observed in clinical trials
Chen J, Kang B, Jiang Q, et al

According to the EMC SmPC, the most commonly reported digestive side effects include: Nausea : Very common (may affect more than 1 in 10 people), typically most pronounced within the first few days after injection and often improving with continued use [1] Vomiting : Common (may affect up to 1 in 10 people), usually associated with eating larger portions than the reduced gastric capacity can comfortably accommodate Abdominal pain and discomfort : Common, resulting from the altered digestive processes Constipation : Common, affecting up to 1 in 10 people due to overall slowing of intestinal transit time Diarrhoea : Common, affecting up to 1 in 10 people, possibly related to altered gut motility patterns Reduced appetite and early satiety : Very common, with patients often feeling uncomfortably full after consuming smaller portions than previously typical These symptoms are generally mild to moderate in severity and tend to diminish as the body adapts to the medication

Thats not going to happen at Costco, Apovian said
Additionally, ChaC1, by stimulating the GCN2/eIF2/ATF4 pathway, enhances necroptosis induced by cystine deprivation (54)
Some patients may experience rebound effects or find that their bodies develop resistance to the medication