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Gallbladder-related events, a risk with rapid weight loss across all obesity medications, occurred in a small percentage of participants and were associated with very rapid early weight loss without adequate dietary fat intake

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However, they're relatively rare

& Grnewald, R

The reason retatrutide and the approved GLP-1s are titrated up over months is side effects: in the Phase 2 trial, jumping to high doses without titration nearly doubled gastrointestinal side effects for the same weight loss (The Lancet, 2023)