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Semaglutide should be kept refrigerated at 2C to 8C ( 36F to 46F )

Additionally a meta-analysis found use of GLP-1RA was associated with higher risk of gallbladder and biliary disease with high doses for longer duration (113)

If these individuals were to follow the ketogenic diet, their bodies would be forced to consume stored protein to gain energy, which will eventually lead to ketoacidosis and possibly fatal outcomes

Diabetes Care, 45(Supplement_1):S8-S16 [DOI] [PubMed] 31.World Health Organization

The body prioritizes metabolic safety over rapid change

Weight loss expectations Cumulative weight loss by week twelve: 5 to 12 percent of starting body weight for most people