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Given the scoping nature of the review and the heterogeneity of available evidence, study selection focused on identifying representative and clinically informative literature rather than exhaustive quantitative inclusion

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Clinical trial results showed modest and variable weight loss outcomes

Although serious GI tract ulcerations and bleeding can occur without warning symptoms, patients should be alert for the signs and symptoms of ulcerations and bleeding, and should ask for medical advice when observing any indicative sign or symptoms including epigastric pain, dyspepsia, melena, and hematemesis

Whilst most patients find that initial fatigue improves within 48 weeks as the body adapts, persistent or severe tiredness warrants medical review to exclude other causes and ensure safe continuation of treatment