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In 2025, the American Association of Clinical Endocrinology updated its Obesity Algorithm, which highlights the importance of preserving skeletal muscle during medical weight-loss interventions: patients who retain strength tend to experience fewer side effects, more energy, and better long-term weight maintenance

Vitamin C, E, B1, B2, B6, B9, B12 and minerals selenium, zinc, magnesium are cofactors for glutathione production

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Options include stepping back to a previous tolerated dose for an additional 4 weeks, reducing the current dose by half and escalating more slowly, or adding prescription anti-nausea medication (ondansetron is commonly used)