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That model skips the very steps that make these drugs safe: a hands-on exam, baseline labs, an EKG when appropriate, and a real review of your metabolism, thyroid history, and cardiovascular health, which matters especially with a stimulant like phentermine and with the thyroid contraindications tied to GLP-1 therapy

Figure 4 Considering that chronic beta-cell GLP-1R signaling activates cAMP-responsive element binding (CREB) and epidermal growth factor receptor (EGFR) pathways that induce pro-survival and anti-apoptotic responses (9294), in addition to the acute potentiation of GSIS, the activation of alpha-cell GLP-1 production may also serve to promote the survival and proliferation of the remaining beta-cells ( Figure 4 )

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GLP-1 agonists and contraception - Patient information leaflet