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One section of the Federal Food, Drug, and Cosmetic Act allows compounding if the drug is changed in a way that makes a significant difference for the patient compared with the commercially available drug
Conversely, others report fatigue or cognitive symptoms, potentially related to rapid weight loss, nutritional changes, or medication side effects

That's more of a natural approach, not as a replacement for medication

Diabetes therapy : research, treatment and education of diabetes and related disorders, 10(2), 341366

Soluble fibre forms a gel-like substance in the gut that slows digestion, stimulates GLP-1 release, and helps regulate blood sugar levels

Peter Dashko Factor Health MD "GLP-1 medications have transformed weight loss medicine