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Common early experiences include: Reduced appetite : Many people notice decreased hunger and earlier satiety during meals within days of the first injection or dose Mild gastrointestinal symptoms : Nausea (affecting 2040% of patients), occasional vomiting, or changes in bowel habits are usually mild and transient Injection site reactions : Minor redness, itching, or discomfort at injection sites is common but typically resolves quickly Fatigue : Some individuals report feeling more tired initially as their body adjusts to reduced calorie intake By weeks 24 , appetite suppression typically becomes more pronounced, and patients often find it easier to adhere to portion control and dietary modifications

Key baseline markers include reduced glutathione (GSH), oxidized glutathione (GSSG), malondialdehyde (MDA), and C-reactive protein to assess oxidative burden

PMID 26978405

Californias board of pharmacy has gone the farthest, revoking Empowers permits and then staying the decision and placing Empower on probation for four years starting in 2023