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Thats why the FDA gives it a boxed warning
FDA thresholds, insurance cutoffs, qualifying conditions, and more.

While newly approved pharmacotherapies such as glucagon-like peptide-1 receptor agonists (GLP-1 RAs) show efficacy, their clinical utility remains constrained by dose-dependent gastrointestinal complications, underscoring the urgent need for safer alternatives

The responsible message: Substantial weight loss usually includes some loss of lean tissue
Adult-onset type 1 diabetes mellitus differs from the early onset form in terms of residual endogenous insulin secretion, comorbidities and baseline cardiorenal risk

Best results are achieved alongside a healthy diet and consistent exercise