While there are varying perspectives on this issue, in a viewpoint that I was pleased to co-author with Sam Klein and Kevin Hall just published in JAMA, we suggest that the concern regarding physical frailty or sarcopenia with GLP-1-based medications may not be as grounded as some argue
Since one of us (S.P.) frequently prescribes GLP-1 receptor agonists for metabolic dysfunction-associated fatty liver disease (MAFLD) patients with obesity, a review of some pearls may be helpful
Not available outside clinical trials
For topiramate, the MHRA now requires a Pregnancy Prevention Programme including pregnancy testing before initiation, highly effective contraception throughout treatment, annual specialist review, and a patient guide with risk acknowledgement
Common Side Effects Nausea (most common, peaks during dose escalation) Diarrhea, constipation, vomiting Decreased appetite, fatigue, headache Injection-site reactions (injectable forms) Rare: pancreatitis, gallbladder disease, kidney injury FDA boxed warning for medullary thyroid carcinoma (do not use with personal or family history of MTC or MEN2) How to Start GLP-1 Treatment See a clinician in-person primary care, endocrinology, obesity medicine, or US telehealth
While this supports weight loss, many people naturally consume less food and drink less fluid throughout the day
