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if pancreatitis is suspected, do not take any further doses and seek urgent medical assessment immediately [15] [16] Pain in the upper right abdomen, or yellowing of the skin or whites of the eyes (jaundice) these may indicate gallbladder disease, a risk associated with rapid weight loss and GLP-1 receptor agonist use [16] [17] Fever accompanying diarrhoea, which may suggest an infective cause requiring separate investigation Significant unintentional weight loss beyond what is expected from the treatment For people with type 2 diabetes: persistent diarrhoea can reduce carbohydrate absorption and increase the risk of hypoglycaemia, particularly if insulin or sulphonylureas are co-prescribed

Brain health should also be incorporated, using cognitive testing and imaging to assess whether these therapies influence neurodegenerative risk

Bromelain The lipolytic effect comes from the protease enzyme bromelain, found in large amounts in pineapples