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People with certain medical conditions need extra caution

GLP-1 receptor agonists stimulate insulin secretion from pancreatic beta cells in a glucose-dependent manner, meaning they promote insulin release only when blood glucose levels are elevated

Morning vs evening injections Morning injections mean any initial side effects (nausea, headache , fatigue ) peak during the day when you are awake and can manage them

The maximum dose is typically reached around week 21-24

Any of these can undermine colonization and force a restart

In a clinical trial, the highest dose of orforglipron led to 11.2 percent weight loss at 72 weeks