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In severe cases, the immune response can affect the whole body, leading to dangerous conditions like anaphylaxis

After 3 years, the improvement in co-morbidities was similar for both groups, except for dyslipidemia and gastroesophageal reflux disease, which responded more effectively to LRYGB treatment

The gradual dose titration schedule as per the SmPC and BNF (starting at 0.25 mg once weekly for four weeks, then increasing to 0.5 mg, with further increases to 1 mg or 2 mg if needed) is specifically designed to minimise these gastrointestinal effects whilst allowing therapeutic benefit

Research into these mechanisms is still evolving, and microdose-level effects have not been specifically studied in clinical trials, but the biological rationale is sound: activating two complementary hormonal pathways at low levels may produce a broader metabolic nudge than activating one pathway alone