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This dangerous combination can rapidly precipitate acute heart failure, fatal pulmonary edema, cardiac arrest, and death (Ebert 2026, Medical Advisory Board 2026a, Medical Advisory Board 2026b)

Others have demonstrated that the positive outcomes of obesity surgery (i.e., changes in body weight and improved glucose homeostasis) are sustained in mice in the absence of GLP-1R or Y2-R, or both GLP-1R and Y2-R 66,67

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Regular monitoring and appropriate dose adjustment of levothyroxine to maintain TSH within the reference range (typically 0.4-4.0 mU/L, though individualised targets may apply) is essential before implementing additional weight management interventions

Attenuated peptide YY release in obese subjects is associated with reduced satiety

N Engl J Med 2008;359:15771589