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It acts on GIP receptor five times over GLP-1 receptor [50]

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Current evidence suggests these medications do not directly cause clinically significant bone loss, though the substantial weight reduction they produce may indirectly influence bone metabolism

10.1158/0008-5472.CAN-21-3230 232 WangY.YangL.ZhangX.CuiW.LiuY.SunQ.-R.et al (2019b)

Rare but serious risks include: Pancreatitis : Severe abdominal pain should prompt immediate medical attention Gallbladder problems : Rapid weight loss can increase gallstone risk Diabetic retinopathy complications : In people with existing eye disease, rapid glucose improvement may temporarily worsen retinopathy, particularly with semaglutide [14] [15] Hypoglycaemia : Low blood sugar is uncommon with GLP-1 agonists alone but can occur if combined with insulin or sulphonylureas [17] [18] GLP-1 agonists are not recognised to directly cause dangerous blood pressure drops (hypotension) in most patients