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Seek medical attention if you experience fatigue accompanied by: Severe gastrointestinal symptoms : Persistent vomiting or diarrhea lasting more than 24 hours, which may lead to dehydration and electrolyte imbalances Signs of dehydration : Decreased urination, dark urine, dizziness, rapid heartbeat, or confusion Abdominal pain : Particularly severe or persistent pain, which could indicate pancreatitis (a rare but serious adverse effect) Right upper quadrant pain : Pain with or without fever, jaundice, or clay-colored stools, which could indicate gallbladder disease Mood changes : New or worsening depression, anxiety, or suicidal thoughts Unexplained weight loss : Rapid weight loss exceeding recommended rates or unintended loss of muscle mass Hypoglycemia symptoms : Shakiness, sweating, confusion, or rapid heartbeat, especially if taking Zepbound with insulin or sulfonylureas