oasis 1 oral semaglutide 50 mg obesity nejm 2023 In the 4 phase 3 trial, once-daily at a dose of 25 resulted in a greater mean reduction in body weight than placebo in participants with overweight or FDA approves once-daily oral Wegovy®

No pharmacokinetic conflict is known

Expected Timeline Weeks 14: Appetite change Weeks 48: Visible weight change Weeks 812: Metabolism becomes more efficient 12+ weeks: Steady monthly results Who Should Avoid GLP-1 (Rare Cases) History of Medullary Thyroid Cancer Family history of MEN2 Uncontrolled hypothyroidism (TSH extremely high) Severe GI disorders (gastroparesis, bowel obstruction) I will not start GLP-1 if your bloodwork is unstable or you show severe symptoms like: Persistent fast heart rate Severe constipation Unmanaged fatigue Gastrointestinal blockage history What to Expect If You Start GLP-1 With Hypothyroidism Heres the exact guidance I give patients: Dose Titration Start low

Even one glass of wine can trigger or worsen sweating episodes several hours later

Recognize that weight fluctuations of 2-5 pounds are normal and do not represent failure