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Nevertheless, this meta-analysis found that treatment with semaglutide was associated with increased occurrence of NAION. Broad Trial Review Shows Neutral Retinopathy Risk Following a comprehensive electronic search of PubMed, Embase, and the Cochrane Central Register of Controlled Trials, the research team assessed ocular adverse events in 78 randomized clinical trials involving 73,640 adults receiving oral or injectable semaglutide

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2 Adverse effects are another significant hurdle

PLoS One 10(3):e0120074 Li PC, Liu LF, Jou MJ, Wang HK (2016) The GLP-1 receptor agonists exendin-4 and liraglutide alleviate oxidative stress and cognitive and micturition deficits induced by middle cerebral artery occlusion in diabetic mice

A fair way to say it: promising science, not a guaranteed clinical outcome