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STEP-5 extended the observation window to 104 weeks (N=304) and found mean weight loss of 15.2% with semaglutide 2.4 mg versus 2.6% placebo, demonstrating that the drug sustains its effect across two full years without clinically meaningful attenuation [10]

[18] [19] Important safety considerations include: Increased risk of hypoglycaemia when combined with insulin or sulfonylureas GLP-1 receptor agonists should not be used in combination with DPP-4 inhibitors [15] [18] These medications are not recommended during pregnancy or breastfeeding You should contact your GP if you experience: Persistent symptoms of hyperglycaemia (excessive thirst, frequent urination, unexplained weight loss) despite lifestyle modifications Difficulty managing your weight despite sustained efforts with diet and exercise Symptoms suggesting complications of diabetes or metabolic syndrome Severe or persistent gastrointestinal symptoms if already taking GLP-1 medications Seek urgent medical attention if you develop severe, persistent abdominal pain (with or without vomiting) which could indicate pancreatitis, or right-sided abdominal pain or yellowing of the skin/eyes which could suggest gallbladder problems

Prescribe GLP-1s for type 2 diabetes, cardiovascular risk or sleep apnea and Part D covers them like any other drug

ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, Collins BS, Cusi K, Das SR, Gibbons CH, Giurini JM, Hilliard ME, Isaacs D, Johnson EL, Kahan S, Khunti K, Kosiborod M, Leon J, Lyons SK, Gabbay RA (2022) Standards of care in diabetes2023

Appetite suppression deepens, heart-rate effects become more visible, and gut symptoms can return after each increase

This is the most challenging scenario