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COA / Lab results Evidence: Clinical trial Pros Triple GLP-1 / GIP / glucagon agonism in one peptide raises energy expenditure, not appetite alone Largest weight reduction reported for an incretin-class compound (~24% at 12 mg, 48-wk phase 2) Reductions in HbA1c, visceral fat and liver-fat content across trials Once-weekly subcutaneous dosing (albumin-bound half-life) Cons GI effects require gradual multi-week dose titration Newest of the GLP-1 class phase 3 (TRIUMPH) topline only

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If you are experiencing problems with alcohol or substance use , you should: Contact your GP to discuss your concerns in a confidential, non-judgemental setting Access specialist addiction services through NHS referral pathways or organisations such as Turning Point, We Are With You, or Alcoholics Anonymous Consider evidence-based treatments including cognitive behavioural therapy, motivational interviewing, and where appropriate, licensed pharmacotherapies Visit NHS support pages for alcohol support (www.nhs.uk/live-well/alcohol-advice/alcohol-support) or drug addiction help (www.nhs.uk/live-well/addiction-support/drug-addiction-getting-help) Contact FRANK (www.talktofrank.com) for confidential drug information and advice If you are already taking a GLP-1 receptor agonist for diabetes or weight management and notice changes in your substance use patterns: Inform your prescribing clinician about any changes you observe Do not alter your medication regimen without medical supervision Continue with your prescribed treatment plan for your licensed indication Seek appropriate addiction support through established pathways if needed Important safety advice: Never obtain GLP-1 medications from unregulated sources or online pharmacies without proper medical oversight These medications require careful dose titration and monitoring for adverse effects Self-medication for addiction is potentially dangerous and may delay access to effective treatments Report any suspected side effects to the MHRA Yellow Card Scheme (yellowcard.mhra.gov.uk) When to seek medical attention: Call 999 for life-threatening symptoms Contact NHS 111 for urgent medical advice when your GP is unavailable Seek immediate medical help for severe, persistent abdominal pain (potential pancreatitis) Signs of allergic reaction (rash, difficulty breathing, facial swelling) Symptoms of severe hypoglycaemia if taking other diabetes medications Any concerning symptoms or medication side effects Whilst research into GLP-1 receptor agonists and addiction continues, patients deserve access to proven, evidence-based treatments