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Although clinically significant hepatotoxicity is less common than other organ toxicities, fatal immune-related liver injury has been reported in some clinical studies and especially in post-marketing setting

Sarcopenia Approximately 40% of the weight reduction associated with GLP-1 RAs is derived from a lean body mass, which raises significant concerns regarding its potential negative impact on skeletal muscle functionality [110]

Hyman mentioned, but would add the importance of education and support.People need to understand why they crave it and and how to combat that craving

Malabsorption Issues: This is often the more complex reason

Avoid repeated freeze-thaw cycles, which can degrade the peptide