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Known adverse effects include gastrointestinal (nausea, vomiting, acute pancreatitis, dehydration and malnutrition), reduced efficacy of oral contraceptives and allergic reactions. Rarer adverse effects include thyroid cell tumours and non-arteritic anterior ischaemic optic neuropathy. Up to 33% of the weight lost is lean tissue mass (muscle and bone). Discontinuation rates can be up to 80% after 2 years. Subsequent weight regain can be up to two-thirds of prior weight loss. There is a risk of much of this regain being fatty tissue. To avoid this and associated malnutrition, GLP-1 RAs should only be initiated along with a supervised exercise programme and individualised dietetic advice. Subsequent patient monitoring to detect cessation, malnutrition and inappropriate fatty tissue weight gain is recommended.<\/jats:p>","DOI":"10.1136\/dtb.2025.000039","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T18:20:22Z","timestamp":1767982822000},"page":"19-23","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Navigating the benefits and harms of GLP-1 and GLP-1\/GIP agonists in obesity"],"prefix":"10.1136","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0042-675X","authenticated-orcid":false,"given":"Raymond","family":"O\u2019Connor","sequence":"first","affiliation":[{"name":"Department of General Practice, University of Limerick School of Medicine, Limerick, Ireland"},{"name":"General Practitioner, Meelick, County Clare, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,1,9]]},"reference":[{"key":"2026021216351639000_64.2.19.1","unstructured":"WHO . 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