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The more accurate concern is that rapid weight loss, reduced lean mass, and decreased mechanical loading may create bone health concerns in some populations, particularly when resistance training is absent

GLP-1 receptor agonists should be considered when patients experience significant weight regain with BMI 27 kg/m with obesity-related comorbidities or BMI 30 kg/m, lifestyle modifications have been insufficient, no anatomical complications require surgical revision, and patients are willing to engage in long-term pharmacotherapy

One of those active in this area is Professor Stefan Trapp at UCL

(Czechia) using validated chromatographic and spectrometric techniques

If weight loss does not accelerate within 8-12 weeks of adding phentermine, the cardiovascular risk is not justified and phentermine should be discontinued