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Immediate consultation is warranted for: Severe or persistent nausea and vomiting lasting more than 48 hours or preventing any oral intake, as this may indicate gastroparesis or require medication adjustment Severe, persistent abdominal pain , which could indicate pancreatitis (a rare but serious adverse effect of GLP-1 medications) Right upper quadrant pain, fever, or yellowing of skin/eyes , which may suggest gallbladder disease (more common during rapid weight loss) Unintentional protein intake below 0.8 grams per kilogram of body weight for more than one week, suggesting inadequate nutritional support Signs of muscle wasting including significant weakness, difficulty with previously manageable physical activities, or visible muscle loss Symptoms of dehydration such as dark urine, dizziness, or decreased urination, particularly when combined with poor protein intake Hair loss, brittle nails, or skin changes that may indicate protein-calorie malnutrition Unexpectedly rapid weight loss exceeding 23 pounds per week consistently, which increases risk of lean mass depletion Routine nutritional assessment should occur at regular intervals during semaglutide treatment