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While no single direct mechanism has been definitively established, fatigue likely results from multiple factors including substantial caloric restriction, gastrointestinal side effects, dehydration, and metabolic adaptation during weight loss

Trunk fat, waist circumference, and triglyceride levels all improved significantly

Its primary action is to promote fat breakdown and reduce fat storage rather than alter appetite, nutrient absorption, or gastrointestinal function

Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, McGowan BM, Rosenstock J, Tran MTD, Wadden TA, Wharton S, Yokote K, Zeuthen N, Kushner RF