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First, some of the muscle change happens with any rapid weight loss, and a portion may be a normal adjustment to a smaller body rather than harmful wasting (Mocciaro and colleagues, BMJ Nutrition Prevention and Health , 2025)
GLP-1 receptors are located in the brain, and GLP-1 is created in the brain in preproglucagon neurons
Common effects are often gastrointestinal, especially after starting treatment or increasing the metformin amount
doi: 10.1111/epi.13809 28
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A less common but possible side effect, due to its breakdown into trimethylamine
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