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While the exact cause is unknown, it could be blamed on the fact that losing weight rapidly can cause something known as metabolic stress

10.1176/APPI.AJP.2019.19121284 [DOI] [PubMed] [Google Scholar] Volkow, N
However, a number of pitfalls in the methodology of these studies (e.g

Patients undergoing treatment for smoking cessation have been observed to consume significantly less alcohol after 12 weeks of treatment with dulaglutide compared to those receiving a placebo, irrespective of their smoking status

The commercial success of any weight loss therapeutic will depend heavily on patient acceptability and adherence, making oral, long-acting depot, and other non-injectable options critical pipeline priorities rather than nice-to-have features

This huge adherence gap means that real-world effectiveness falls far short of trial efficacy
