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While there's no peer-reviewed data on why this happens, according to Rob Stransky, president of the telehealth provider NiceRx, this can happen because of how these drugs slow the body's gastric emptying process, or how food moves away from the stomach into the small intestine

If you thought the ED visits and poison control calls associated with the first wave of long-acting GLP-1s were concerning, wait until a far more potent therapy reaches broad scale without appropriate oversight

The structural complexity (~39 amino acids with fatty acid conjugation) makes retatrutide one of the most demanding compounds to manufacture in the Durham Peptides catalog: Long peptide sequence more SPPS coupling cycles per molecule Fatty acid conjugation specialized synthetic chemistry beyond standard peptide synthesis Complex purification separating the desired modified compound from unconjugated and partially-conjugated variants Demanding analytical characterization confirming both peptide identity and modification For complete coverage of how manufacturing complexity drives pricing, see Why Some Peptides Cost More Than Others: Manufacturing Complexity Explained

Some are basically sugar water with marketing