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Common side effects include: Nausea Vomiting Diarrhea Decreased appetite Headache Stomach pain Fatigue Constipation Dizziness Heartburn Bloating and gas Low blood sugar (especially with insulin or sulfonylureas) Mood changes Serious, but rare side effects may include: Severe allergic reactions Pancreatitis Gallstones Kidney problems Worsening diabetic retinopathy Heart rate changes Suicidal thoughts or behaviors Thyroid cancer Bowel obstruction This is not a complete list

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Gastrointestinal events have appeared most frequently in trials (nausea, vomiting, diarrhea)

Rather, he thinks their ability to reduce appetite occurs by stimulation of parts of the brain that sit outside the bloodbrain barrier the selective semi-permeable membrane that keeps most large molecules out