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Younes A, Pugh W, Goodacre A, Katz R, Rodriguez MA, Hill D, Cabanillas F, Andreeff M

What specific risks must be emphasized when counseling high-risk patients about GLP-1 therapy, and how do you document this patient education/ informed consent

Excessive weight gain and central obesity (usually begins after age 2 years) Higher pain threshold Substantially slow metabolic rate Hypothalamic hypogonadism Scoliosis and/or kyphosis Sleep-disordered breathing, central sleep apnea (under age 2 years), obstructive sleep apnea, hypoventilation, excessive daytime sleepiness, narcolepsy, cataplexy Small hands and feet Articulation challenges, Apraxia of Speech, hypernasal speech, language processing challenges Thick viscous saliva Absent vomit reflex or elevated vomiting threshold Temperature regulation irregularities Temperament, emotional regulation, and behavioral challenges beginning after age 2 years Clinical Symptoms in Older Children and Adults without intervention: Symptoms in the young children and: Hyperphagia: insatiable drive to eat or find food to eat later, lack of normal satiety

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A potential drawback of such a therapy is that the beneficial effects of 3-AR require BAT (96-98), which may be a paucity in humans (231)