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That's a reason to keep on top of your nutrition and strength-training while on these drugs, he writes, "especially for older people like me, who are [already] susceptible to muscle loss." There are people who should steer clear of GLP-1 drugs, Kessler notes, including those with a personal or familial history of certain thyroid and endocrine cancers, those with chronic kidney disease, pancreatitis, inflammatory bowel diseases, uncontrolled diarrhea or constipation or gastroparesis, or if you are pregnant

While metformin is often prescribed to non-pregnant people with T2DM, other drugs or insulin may be added or substituted for metformin if adequate blood sugar control is not achieved

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I also wrote up the SURMOUNT-MAINTAIN dose-reduction trial separately, which addresses what most people want to know once they have hit their target weight