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The honest answer is that the risk is real and the evidence is concerning enough to avoid it

Experimental studies provide strong evidence that insulin resistance-related neuroinflammation feeds cognitive impairment neuropathology, leading to a raised-up brain levels of pro-inflammatory cytokines (Mullins et al., 2017

Think nausea, vomiting, diarrhea, abdominal pain, constipation, gas, burping, acid reflux, and indigestion

For context, a person starting at 300 lbs could expect to lose around 45 lbs

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Rybelsus starts working within a few hours of taking it, and it reaches its maximum effect within 4 to 12 weeks of starting treatment