It may be rare or even unrelated or whatever but I read one story where a woman who was in one of these drugs had massive bone density loss. It basically destroyed her body. I think the message was you have to be extremely careful about maintaining proper diet and or exercise with these drugs or they will interact with you body in damaging ways. To be fair I haven't put in much research. In general I'm skeptical about "miracle" weight loss drugs and worry about what future negative findings may come based on past drugs developed and their eventual bad outcomes.
Well, if you care to look, some data is out there:
Systematic review
Results: Based on the articles included, the animal studies indicated the salutary skeletal effects of GLP1RAs in opposition to what has been commonly observed in human studies, showing that these agents have no impact on bone mineral density (BMD) and the turnover markers. Moreover, it was demonstrated that GLP1 was not associated with fracture risk as compared to other anti-hyperglycemic drugs.
Conclusions: Findings from this systematic review have demonstrated the neutral impact of GLP1RAs on BMD. Moreover, further double-blind randomized controlled trials are needed to draw more meaningful and significant conclusions on the efficacy of GLP1RAs on BMD.
Meanwhile, we know these drugs are nearly as good as bariatric surgery for sustained weight loss, 3-4X as good as behavioral modification alone, and improve the risk from multiple obesity complications (e.g. diabetes, cardiovascular disease, heart failure, kidney disease, sleep apnea). As a result, all-cause mortality is reduced 10-20% in those taking GLP-1 agonists.
I certainly understand your reluctance, but at some point, hesitancy over potential problems has to be weighed against the growing body of favorable data, and ongoing harm caused by excess weight.