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While Novo Nordisk and rival obesity therapy manufacturer Eli Lilly are starting to overcome the production constraints that coupled with massive demand have resulted in shortages, Noom's WSJ ad calls for US policymakers to keep the status in place "until GLP-1s cost the same in NYC and London." The FDA has received adverse event reports involving patients who have used them and has taken action against some compounders making versions available based on salt forms of the drug that are unapproved, including semaglutide sodium and semaglutide acetate, so the availability of compounded forms has become controversial

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On the other hand, cell death exposes the basement membrane, to which crystals bind directly and on which regenerating epithelium grows, pushing the crystals into the interstitium and promoting crystal retention