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That is worth saying plainly, because the same review this page cites (Urbina 2026) found thiamine and cobalamin deficits increase over time on GLP-1 therapy, and that in patients with rapid weight loss, persistent vomiting, or very poor oral intake, suspected thiamine deficiency is a medical urgency

230:639-648 (2009) Moghe A, Ghare S, Lamoreau B, Mohammad M, Barve S, McClain C, Joshi-Barve S

GLP-1 receptor agonists work through several mechanisms: they enhance insulin secretion when blood glucose levels are elevated, suppress glucagon release (which reduces glucose production by the liver), slow gastric emptying, and promote satiety through effects on appetite centres in the brain

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