The pivotal trials are STEP (semaglutide for weight management, The New England Journal of Medicine , 2021), SURMOUNT (tirzepatide for weight management, NEJM 2022), and SURMOUNT-OSA (tirzepatide for obstructive sleep apnea, NEJM 2024)
Unfortunately, you may not even be aware that these side effects are occurring, and you keep taking methylfolate because you mistakenly think you need to, which only makes things worse
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Current FDA labels document these patterns in detail: Wegovy (semaglutide) lists nausea (44% vs 16% placebo), vomiting (25% vs 6%), diarrhea (30% vs 16%), constipation (24% vs 11%), abdominal distension and eructation, with severe GI events in 4.1% versus 0.9% placebo.[2] Zepbound (tirzepatide) lists nausea, diarrhea, vomiting, constipation, abdominal pain, dyspepsia, eructation, and gastroesophageal reflux disease among common adverse reactions, with severe GI disease as a Warnings and Precautions item.[3] Both labels include postmarketing reports of ileus, severe constipation including fecal impaction, and acute kidney injury related to dehydration from severe GI symptoms