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Metformin, a first-line T2DM treatment, affects the gastrointestinal tract by altering glucose uptake, GLP-1 secretion, gut microbiota, and immune response [33, 34], but it rarely causes bowel obstruction

doi: 10.3390/ijms25073812, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar] 85.Meissner WG, Remy P, Giordana C, Maltete D, Derkinderen P, Houeto JL, et al

Zepbound is a bit more effective because it affects more than just GLP-1 it affects other receptors

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