Neuropsychopharmacology 39 (2), 329338

concomitant risk factors (hypertension, dyslipidemia), diabetic complications (peripheral artery disease, myocardial infarction, ischemic heart disease, stroke or transient ischemic attackTIA, heart failure, cardiovascular disease, neurological complications, ocular complications, renal complications, chronic kidney diseaseCKD), history of severe hypoglycemia, other comorbidities (chronic pulmonary disease, systemic inflammatory disease, cancer), the Charlson comorbidity (derived from administrative claims as previously described [24, 25]), the number of different A10B-class drugs (blood glucose lowering drugs, excluding insulins), use of glucose lowering medications in the year before the index date (metformin, sulfonylureas, SGLT-2i, pioglitazone), and use of other drugs in the year before the index date (ACE inhibitors, diuretics, beta blockers, other blood pressure lowering drugs, statins, fibrates or omega-3, PCSK9 inhibitors, ezetimibe, and anti-platelet agents)

It is a self-reinforcing cycle that is hard to interrupt with any single intervention
However, the FDA does not regulate the efficacy or safety of compounded drug products
PMID: 81 HenningYBlindUSLarafaSMatschkeJFandreyJ
#19 Roughly 3.25lbs/week loss is too much