More substantial cognitive benefits, including memory enhancement and improved learning capacity, typically develop over 6 to 12 weeks as synaptic density increases
& Terpstra, M
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Clinical trials show average weight loss of 15% to 22% of total body weight, depending on the specific medication and dosage used

Serious Warning Signs Severe abdominal pain: Especially if sudden onset, radiating to back, or with vomiting (possible pancreatitis, occurred in 0.3% of patients) Severe vomiting: If unable to keep any fluids down for 24 hours (dehydration risk) Signs of dehydration: Dark urine, dizziness on standing, confusion, decreased urination (acute kidney injury risk) Vision changes: Blurred vision, eye pain (rare but requires evaluation) Rapid heart rate: Persistent heart rate over 100 at rest (some increase normal, average 2-4 bpm, but sustained tachycardia needs evaluation) Suicidal thoughts: Any thoughts of self-harm (under 1% occurrence but requires immediate support) Severe allergic reaction: Difficulty breathing, throat swelling, severe rash (anaphylaxis requires emergency care) Lump in neck: Especially with difficulty swallowing (thyroid concern, rare but part of class warning) Trust your instincts

The mechanism is thought to relate to rapid metabolic changes causing temporary worsening of retinal ischaemia before long-term benefits accrue