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Over time, however, clinical guidelines have expanded their role significantly

Medullary thyroid cancer concerns GLP-1 RAs carry a black box warning for thyroid C-cell tumors, including medullary thyroid carcinoma (MTC)

doi: 10.1136/bmjpo-2019-000624

The escalation is essential to reduce the frequent GI side effects, such as seen below in the tirzepatide trial

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Consistent with these findings, peripherally administered CCK induces cFos immunoreactivity in GLP-1-producing neurons of the hindbrain vagal complex of the NTS [354], and surgical vagal deafferentation reduces CCK-induced NTS neuronal cFos activation by approximately 50% [355]