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Risks, Side Effects, and What Honest Prescribing Looks Like Common and Expected Side Effects Nausea, vomiting, diarrhea, constipation most common, especially during dose titration Gastric emptying delay with gastroparesis-like symptoms clinically significant for patients on structured meal plans Fatigue, particularly early in treatment Hair thinning with higher doses or prolonged caloric restriction Dehydration secondary to gastrointestinal effects Serious but Less Common Risks Acute pancreatitis requires immediate cessation and medical management Gallbladder disease increased incidence with rapid weight loss Thyroid C-cell tumor risk observed in animal studies

Some changes may be visible, such as discoloration or cloudiness, but the absence of visible change does not always answer the stability question

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Vegans, vegetarians and people with diets high in processed foods