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Observations of variable lean mass outcomes and dietary shifts during GLP-1RA therapy [40, 75] suggest that substrate availability may influence therapeutic durability even in the absence of overt deficiency
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However, in the subgroup of patients with insulin resistance, severe obesity and higher odds ratio for the metabolic syndrome, BMI decreased more with liraglutide than with metformin (2.13 kg/m 2 vs

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GLP-1 medications are contraindicated in patients with personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2
