Genuinely get where this is coming from. There's a patient, late seventies, who shed a large amount of weight using this drug class. Everyone assumed hip and knee discomfort would ease up, yet oddly it got worse once the pounds came off.
A full workup revealed the medication probably wasn't really to blame. Advanced joint deterioration had been quietly present for a long time, and all that extra padding had been unintentionally propping up and supporting those joints for years. Once so much of it disappeared, the joints lost their built-in buffer, and natural muscle decline that comes with age likely added to the instability too. Not that fat literally holds a skeleton together, but it does function as a cushion, while muscle and connective tissue carry the real structural load.
Treatment actually got halted for a stretch since the suspicion pointed at the medication itself. Unfortunately the weight crept back during that pause, so it resumed at a much smaller upkeep dose, which has gone far better since.
Given the age involved here, staying open-minded feels worthwhile. Fatigue, constipation, and weakened muscles...