B12 inclusion theoretically mitigates this, but it cannot completely compensate for a 500-1000 calorie daily deficit
Semaglutide and Atrial Fibrillation: A Population-Based Cohort Study of Patients with Type 2 Diabetes. Diabetes, 72(Supplement 1), 2023
The report also discusses safety controversies (such as past concerns about pancreatitis and thyroid tumors) and how they have been addressed by research and regulatory reviews

Seek immediate medical attention for: Severe, persistent abdominal pain that does not resolve or worsens over hours Vomiting blood (hematemesis) or material that looks like coffee grounds Black, tarry stools (melena) or visible blood in stools, suggesting gastrointestinal bleeding Severe nausea and vomiting preventing adequate fluid intake or lasting more than 24 hours Signs of dehydration including decreased urination, dizziness, or confusion Sudden, sharp abdominal pain with rigidity, potentially indicating perforation Progressive dysphagia (difficulty swallowing) Persistent vomiting despite medication adjustments Schedule a non-urgent appointment for: Persistent upper abdominal discomfort or burning sensation lasting more than two weeks Recurrent dyspepsia not responding to dietary modifications New or worsening heartburn or acid reflux symptoms Unexplained fatigue potentially indicating anemia from chronic blood loss Unintended, disproportionate, or symptomatic weight loss distinct from expected medication effects According to American College of Gastroenterology guidelines, patients aged 60 or older with new-onset dyspepsia should undergo prompt endoscopic evaluation, as should patients of any age with alarm features
