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Based on clinical trials and FDA labeling, gastrointestinal side effects, including diarrhea, commonly occur early in treatment and with dose increases, then tend to lessen after dose stabilization

Dahl D, Onishi Y, Norwood P, Huh R, Bray R, Patel H, et al

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Combining a GLP-1 with insulin or certain other diabetes drugs can push blood sugar too low, which is exactly the kind of thing a doctor adjusts for before you take a first dose

Bariatric surgery involves major surgical intervention and carries both short-term surgical risks and long-term nutritional considerations

Because these drugs affect the central nervous system, mental-health outcomes are a foreseeable safety issue, even if the precise level of risk remains uncertain