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An important consideration for dual and tri-agonist peptides, is to monitor and clarify the clinical consequences on the cardiovascular system, especially the heart rate increase (147, 148)

Ghrelin - a new gastroprotective factor for gastric mucosa

Nature Reviews Disease Primers , 14

This multicenter, double-blind, placebo-controlled trial enrolled people with NAFLD with liver fat content at or above 10% by MRI-PDFF, a FibroScan liver stiffness measure below 10 kPa, alanine aminotransferase (ALT) at or below 75 IU/L, and no diabetes or non-insulin-dependent diabetes with A1C below 9.5%

Also, longer studies show people keep off the weight for years