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Avoid combining with other stimulants during the initial adaptation period

In the STEP trials, semaglutide produced average weight loss of 1518% at the 2.4 mg maintenance dose, with approximately 80% of participants achieving clinically significant (5%) weight loss

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doi: 10.2131/jts.34.501

Dysbiosis is known to cause poor health in the linings of our gastro intestinal tract and if you have poor health in the linings of the gastro intestinal tract the L cells wont produce as much GLP-1 and you will start to lose all of those trophic benefits that I just mentioned

Elderly Patients Older adults often have reduced stomach acid or atrophic gastritis, leading to poor B12 absorption