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An endometrioma would be in your differential

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Furthermore, MC4R KO mice showed characteristics of insulin resistance, as their glucose levels were comparable to those of normal mice, despite elevated insulin levels (Table 1)

Warning signs requiring prompt evaluation include: Rectal bleeding or blood in stool Unexplained weight loss (beyond expected medication effect) Persistent change in bowel habits lasting more than a few weeks New-onset abdominal pain that differs from typical GLP-1 side effects Iron-deficiency anemia These symptoms warrant investigation regardless of medication use, as they may indicate various gastrointestinal conditions requiring diagnosis

Concurrently, L-carnitine may enhance neovascularization, further complicating the disease landscape

However, that dream body might be more achievable than you think