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According to obesity medicine insights, fatigue may result from appetite suppression, reduced calorie intake, or changes in hydration and blood sugar

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Patients should be advised to: Start with the lowest dose and increase slowly Eat smaller, more frequent meals Avoid high-fat foods Stay well-hydrated Safety monitoring should include vigilance for: Pancreatitis symptoms (severe persistent abdominal pain) discontinue immediately if suspected Gallbladder disease increased risk with rapid weight loss Hypoglycaemia particularly when combined with insulin or sulphonylureas Renal function deterioration especially with dehydration from gastrointestinal effects Diabetic retinopathy monitor in patients with pre-existing retinopathy, particularly with semaglutide Suspected adverse reactions should be reported via the MHRA Yellow Card scheme

Compounders had been allowed to produce hundreds of thousands of doses of copies of Novo's obesity and diabetes drugs only while the FDA said they were in short supply