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Alternative medication classes should be considered if GLP-1 therapy proves intolerable: SGLT2 inhibitors (such as dapagliflozin, empagliflozin) for type 2 diabetes, which work via a completely different mechanism and rarely cause gastrointestinal side effects DPP-4 inhibitors (such as sitagliptin, linagliptin), which enhance endogenous GLP-1 activity more gently Metformin remains first-line for type 2 diabetes, though it can also cause gastrointestinal side effects Orlistat for weight management, though this also has gastrointestinal side effects of a different nature For weight management specifically, NICE recommends a comprehensive approach including dietary modification, increased physical activity, and behavioural interventions, with or without pharmacotherapy

Weight loss itself also leads to changes in hormones, which could also contribute to changes in these senses, Dr

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doi: 10.1097/MED.0000000000000087