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The following timeline, based on clinical trial data from Eli Lilly, shows the typical progression: Appetite suppression typically begins around day 3 of the first dose, with significant feelings of fullness developing by week 2

This results in a decrease in the frequency and amplitude of GnRH pulses and a reduction in gonadotropin levels

The safety profile of concomitant GLP-1 receptor agonist and metformin therapy remains controversial in current literature

Current 2024 multi-society guidance suggests most patients can continue GLP-1 agonist therapy with appropriate risk stratification rather than routine holds

95% CI 0.04, 0) (Fig

Clinicians avoid combining therapy with dipeptidyl peptidase-4 inhibitors due to minimal glycemic benefits and increased hypoglycemic risk (30)