It's not safe for people with heart disease or certain other conditions
in a meta-analysis of randomized controlled trials reported an increase in adiponectin concentrations in the course of GLP-1RA therapy [32]
Clinical studies have shown that patients treated with GLP-1 receptor agonists not only experience significant weight loss but also improvements in associated health markers, such as blood pressure and lipid profiles
Situations with an excess uptake of lipids by the liver require an adaptive increase in mitochondrial oxidative capacity

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So when estrogen levels are going down, this isn't happening in early perimenopause, but it is happening in the later half