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Musculoskeletal strain : Rapid weight loss associated with semaglutide may alter body mechanics, posture, and center of gravity, potentially contributing to mechanical lower back pain

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20 Possible mechanisms are: natriuresis, due to increased atrial natriuretic peptide secretion, GLP-1R activation in the proximal nephron tubule and Na + /H + transporter inhibition (which reduces sodium reabsorption), as well as vasodilation due to nitric oxide-dependent vasodilation (endothelial GLP-1R activation) and direct effects on smooth muscle cells GLP-1R