Bariatric surgery history: altered anatomy, altered expectations posts 31–40

Renal impairment: the compounds are cleared renally to some degree. Dose adjustments might be needed in severe renal impairment. Consulting with a clinician familiar with renal dosing is prudent.

Hepatic impairment: less is known about dosing in significant liver disease than in kidney disease. Extreme caution applies because the liver metabolises a large fraction of many medications.

Coming back to post #31, because the follow-up matters more than the original answer.

Disordered eating history: a history of anorexia nervosa, bulimia, or other eating disorders changes the risk-benefit calculation because appetite suppression might trigger relapse. This population requires specialist input.

Picking up post #31: that is the part I would want checked first.

Hypoglycemia risk: in people already on insulin or sulfonylureas, adding a GLP-1 agonist requires insulin dose reduction and close monitoring for hypoglycemia. This is manageable with attention.

Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing.

The correction was fair and I had been repeating something I had not checked carefully enough.

post #35 is right about the mechanism and I think understates the practical bit.

Medullary thyroid carcinoma history: an absolute contraindication because of the preclinical findings in rodent toxicology. The history (personal or family, especially multiple endocrine neoplasia type 2) is an important screening question.

I read post #35 twice before replying, because I had assumed the opposite.

Gastroparesis: pre-existing severe delayed gastric emptying can worsen with compounds that slow it further. Discussion with a clinician is prudent if this history exists.

Disordered eating history: a history of anorexia nervosa, bulimia, or other eating disorders changes the risk-benefit calculation because appetite suppression might trigger relapse. This population requires specialist input.

Thank you for the correction. I have edited my earlier post with a note rather than silently, so the thread still makes sense to read. The error was mine and it was the kind that comes from remembering a figure instead of looking it up.