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It has been used for decades to manage nausea in various clinical contexts, most notably pregnancy-related nausea

GLP-1 generics would be dramatically cheaper than U.S price of Ozempic, study shows, but still profitable

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And then you add bariatric surgery when medications dont work.

Renal Disease In a renal impairment study, venlafaxine elimination half-life after oral administration was prolonged by about 50% and clearance was reduced by about 24% in renally impaired patients (GFR = 10-70 mL/min), compared to normal subjects

So it's, that's what's like, mind blowing to me