does semaglutide increase cholesterol and Cholesterol: Clinical Effects Explained Best GLP-1s for High Cholesterol?:

It is important to note that modern clinical guidance does not recommend routinely restricting protein intake in people with advanced liver disease, including cirrhosis

Fatigue Fatigue is often reported during the initial adjustment period and is usually related to changes in caloric intake and blood sugar regulation rather than the medication itself

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Similarly, changes in insulin receptor levels may alter dynamics of oscillation of glycemia, insulinemia and glycogen without changing food intake pattern or clock gene expression, but insulin has also been shown to act as zeitgeber for the liver clock 130,131

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Regulatory approval requires comprehensive dossiers including clinical efficacy, safety data, manufacturing standards, and pharmacovigilance plans