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Patients should contact their GP or prescribing clinician if they experience : Sudden onset of skin changes disproportionate to weight loss Areas of skin that appear abnormally thin, fragile, or prone to tearing Easy bruising or poor wound healing Development of striae (stretch marks) during weight loss rather than weight gain Skin changes accompanied by other symptoms such as muscle weakness, fatigue, or mood disturbances Purple/wide striae with easy bruising and proximal muscle weakness (which may suggest Cushing's syndrome) Seek same-day care or emergency help for severe allergic reactions, rapidly spreading rash, or unexplained extensive bruising or bleeding

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