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Patients treated with GLP-1 therapies were experiencing significant weight reduction, sometimes exceeding 15% of body weight in clinical studies when combined with lifestyle changes
Rybelsus was never approved by the FDA for weight loss
Because weak carbonic-anhydrase inhibition can precipitate non-anion-gap metabolic acidosis, caution or avoidance is warranted in patients with chronic metabolic acidosis, severe pulmonary disease with chronic hypercapnia, or conditions pre-disposing to osteoporosis, nephrolithiasis, or nephrocalcinosis