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The SELECT trial followed over 17,600 patients taking semaglutide for an average of nearly 4 years

6.7% of patients taking GLP-1 developed NAION compared to 0.8% of patients taking other medications

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Common side effects Injection-site reactions: mild redness, tenderness, swelling, occasional bruising - usually resolve within hours Skin flushing / warmth - brief, related to vasodilation Transient fatigue in the first 12 weeks of intensive protocols Mild headache - usually dose-related Higher-dose theoretical concerns Copper accumulation - each 2 mg injection adds roughly 0.03 mg of elemental copper, trivial next to the 0.92.2 mg from a normal diet