Type 1 diabetes: off-label use and the evidence gap — what changed since

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.

For anyone arriving from a search: the marked solution above is the direct answer, and the replies underneath it add the caveats that make it safe to use.

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.

Pancreatitis history: the compounds can rarely trigger pancreatitis. A history of pancreatitis makes monitoring for recurrence more important during titration.

Adolescents: a distinct evidence base exists. The compounds are not approved for routine adolescent obesity but are being studied. Adolescent physiology and psychology differ from adults' in ways that matter for this medication class.

Pancreatitis history: the compounds can rarely trigger pancreatitis. A history of pancreatitis makes monitoring for recurrence more important during titration.

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.

This follows post #74 rather than contradicting it.

I disagree with the reply above, and I think the disagreement is substantive rather than terminological.

The distinction being drawn does not survive when you look at the published data for this specific question. I would be glad to be shown wrong on this, because the version I am arguing against is more convenient.