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When compared with placebo or other therapies, GLP-1 agonists were associated with an increased risk of biliary disease [23]: Overall biliary disease: RR 1.37(95% CI 1.231.52) Cholelithiasis: RR 1.27 (95% CI 1.101.47) Cholecystitis: RR 1.36 (95% CI 1.141.62) Mechanisms: Reduced gallbladder motility Rapid weight loss increased cholesterol saturation and gallstone formation

Some patients may experience gastrointestinal complications like gastroparesis or reflux, and rare risks include pancreatitis or low blood pressure

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In June, the European Medicines Agencys PRAC identified NAION as a very rare adverse event linked to semaglutide and recommended updating product labels with vision warnings

The central GLP-1: implications for food and drug reward