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As Epictetus might say, its not the drug that matters, but how we use it

The lack of clarity makes choosing a company potentially confusing for patients, and the medical profession is partly to blame, said Jamy Ard, an obesity doctor and researcher at Wake Forest University School of Medicine in Winston-Salem, North Carolina

Disha Narang, an endocrinologist and director of obesity medicine at Endeavor Health

This significant reduction underscores the efficacy of VNS in modulating food intake and energy expenditure (Yao et al., 2018)

How long will it take to notice benefits

Patient safety guidance should include: Education about expected appetite changes and strategies for maintaining adequate nutrition Monitoring for excessive weight loss or signs of malnutrition Assessment of mental health at follow-up visits Clear instructions to report severe or persistent nausea, vomiting, or neuropsychiatric symptoms Awareness that cognitive effects remain investigational and should not influence prescribing decisions Reporting severe persistent abdominal pain (pancreatitis), right upper quadrant pain/jaundice (gallbladder disease), severe abdominal distension with inability to pass gas or stool (possible ileus), persistent vomiting or signs of dehydration, and new/worsening vision changes (retinopathy) Understanding increased hypoglycemia risk when combined with insulin or sulfonylureas GLP-1 receptor agonists are contraindicated in patients with personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2, and should be used with caution in patients with severe gastrointestinal disease, including gastroparesis