The most common are gastrointestinal: nausea (experienced by 20-40% of patients, usually diminishing over time), vomiting, diarrhea, constipation, abdominal discomfort, and reduced appetite (which contributes to therapeutic effects but can be excessive for some patients)
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2.2.5 Metabolic reprogramming Metabolic reprogramming refers to the process in which cells, under specific physiological and pathological conditions, systematically adjust and transform their metabolic patterns to adapt to changes in the external environment and to meet their own needs for growth and differentiation, by engaging various bioenergetic routes, such as glucose utilization, lipid metabolism, and amino acid metabolism (Xia et al., 2021
Hou YC, Hu Q, Huang J, Fang JY, Xiong H
This contributes to its incredible efficacyit is very hard to overeat when gastric emptying is significantly delayedbut it also suggests that titration (starting low and going slow) is vital to manage gastrointestinal comfort