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Before anyone considers GLP-1 therapy at any dose let me be clear about who needs to avoid these medications: Personal or family history of medullary thyroid cancer or MEN-2 syndrome contraindicated History of pancreatitis may not be safe Severe gastroparesis these drugs will worsen it Pregnancy or active conception planning not recommended These are real medications with real side effects: nausea, vomiting, constipation, gallbladder problems