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T.SuH.-Y.MoroA.ChangH.-H.EiblG.et al (2016)

Current evidence suggests that GLP-1 receptor agonists can be safely used in patients with well-controlled hypothyroidism, though several important considerations warrant attention

When muscle is lost during weight management, it can result in: Decreased metabolic rate Reduced physical strength and endurance Difficulty maintaining weight loss long-term Diminished quality of life and functional capacity For those using medical weight management approaches, these concerns become even more pressing, as the accelerated weight loss can sometimes lead to greater muscle breakdown without proper nutritional support

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The study enrolled the first 27 children in Poland treated with mecasermin for SPIGFD and it does not appear that there is a substantial risk of selection bias