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The initial muscle loss seen with GLP-1 RA treatment as well as the ongoing replacement of muscle with fat with treatment cycles involving treatment interruptions can result in unfavorable changes in body composition in patients with obesity that can have profoundly negative repercussions, and can exacerbate obesity-related metabolic and health concerns 14,15,16

Nasal spray provides systemic distribution that may dilute effects at a specific location

Despite inconclusive evidence on the link between IGF-1 and pediatric obesity, some studies have shown that increased circulating IGF-1 in pre-pubertal children with obesity may be associated with increased nutritional status or dysregulation of other hormones [70,71,72,73] Elevated IGF-1, along with hyperinsulinemia, increased leptin, thyroid hormones, and sex steroids, may contribute to accelerated skeletal maturation in children with obesity [74]

The most common ones tend to be gastrointestinal in nature, like nausea, diarrhea, abdominal pain, and constipation although its possible to have more serious (but much rarer) events like inflammation in the pancreas and an increased risk of thyroid cancer