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Seek urgent medical attention immediately if you experience: Severe or persistent abdominal pain , with or without vomiting, fever, or jaundice these may be symptoms of pancreatitis or gallbladder disease, which are recognised risks with GLP-1-based therapies (see NHS information on pancreatitis and gallstones) [5] [25] Chest pain or acute breathlessness , which require emergency assessment Significant swelling of the legs, ankles, or abdomen, particularly if accompanied by breathlessness, which may suggest a cardiovascular concern Seek prompt (non-emergency) medical advice if you notice: Unexplained or rapid weight gain for example, approximately 2 kg or more within 3 days without an obvious dietary cause, or a consistent upward trend over several weeks New or worsening symptoms such as persistent fatigue, cold intolerance, hair loss, or irregular periods, which could indicate an underlying thyroid or hormonal condition Persistent nausea, vomiting, or abdominal discomfort that is affecting your ability to maintain adequate nutrition Mood changes or disordered eating patterns that are affecting your relationship with food Even outside these specific triggers, if you feel that your treatment is not working as expected after several weeks at a stable dose, a review with your prescriber is entirely appropriate