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Serious risks can be mitigated by careful patient selection (avoiding those with unstable cardiovascular conditions) and adhering to recommended dosing frequency
modeled estimates place the 1 mg response closer to +2 to +5 bpm. Lower starting lean mass leaves less reserve during rapid loss, which makes strength and protein intake more important outcomes than scale change alone
Enhanced blood vessel formation could theoretically support tumor growth and spread
Three specific conditions qualify for Tier 2 (BMI 30 or higher): (1) heart failure with preserved ejection fraction (HFpEF), (2) uncontrolled hypertension despite treatment with two or more antihypertensive medications (systolic over 140 or diastolic over 90), and (3) chronic kidney disease stage 3a or higher (estimated GFR below 60)
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