A lot of clinicians think they do, but he is not persuaded
According to FDA guidance, GLP-1 medications are not recommended for people who have: Pregnancy, because safety data are limited and pregnancy requires appropriate weight gain and nutrient storage A prior history of pancreatitis, due to a risk of triggering inflammation of the pancreas A history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 (MEN2), a rare genetic condition linked to thyroid cancer in animal studies A clinician will review your medical history carefully to determine whether these medications are appropriate for you
In UK clinical practice, co-prescribing a GLP-1 receptor agonist (like Rybelsus) with a DPP-4 inhibitor (like Januvia) is generally not recommended
On one hand, a large 2024 cohort study (over 160,000 patients with obesity) reported a significantly higher incidence of new psychiatric diagnoses among GLP-1 RA users: an ~98% increase in risk of any psychiatric disorder compared to matched non-users, including a 195% higher risk of major depression and ~106% higher risk of suicidal behavior (Scientific Reports 2024)
Safety note The most notable is the heart rate increase observed in the retatrutide Phase 2 trial
If you are pregnant or suspect pregnancy GLP-1 medications are contraindicated during pregnancy
