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Sanjay Kaul, a frequent FDA advisor, pointed out the paradox of the large commercial success of the diabetes drugs despite the absence of any proven clinical benefit: "So, we have a drug that yields modest glycemic efficacy, is neutral with respect to cardiometabolic factors (lipids, weight, blood pressure), does not kill you or land you in a hospital, and yet is a blockbuster drug nearly 5 times over

Layer P, Holst JJ, Grandt D, and Goebell H

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This typically peaks in week two before gradually improving as your body adapts to the medication's effects on gastric motility