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These include improvement in MASLD-related steatohepatitis and steatosis,155,156 knee pain in osteoarthritis,106 cardiovascular outcomes,99 and potentially substance use disorders.157 Common side effects of GLP-1 agonists include nausea, constipation, diarrhea, vomiting, abdominal discomfort, and reduced appetite.63,67,148,158 Side effects tend to be transient and resolve with time, but impact real-world adherence.159 Patients on GLP-1 receptor agonists do lose muscle mass, as is commonly seen with all forms of weight loss.160 Serious adverse events include gallbladder and biliary disease, which are believed to be dose-related and result from GLP-1 inhibiting gallbladder emptying through CCK suppression.120,140 Contraindications to use of GLP-1 receptor agonists include medullary thyroid carcinoma, family history of MEN type 2 syndrome, pancreatitis, and relative contraindications include diabetic retinopathy and uncontrolled diabetes.161,162 Given the recent approvals of these anti-obesity medications, providers and patients are undoubtedly concerned about what long-term safety data is available

The FDA does not regulate dietary supplements with the same rigor as prescription drugs, leading to potential inconsistencies in quality and efficacy