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A woman in her 70s with type 2 diabetes mellitus (DM) and class 3 obesity (body mass index (BMI): 51.1 kg/m 2) had been treated with a weekly 0.25 mg of semaglutide injection for DM by a physician in another hospital. She was often confined to bed because of bilateral knee osteoarthritis. Due to the favourable progression of her condition, the dosage of semaglutide was increased to 0.5 mg; however, frequent vomiting occurred in 1 week. Although vomiting was persistent, the semaglutide treatment was continued because a reduction in body weight was achieved (BMI: 42.2 kg/m2). Six months later, she was unable to consume food and was subsequently referred to our hospital and admitted due to exacerbation of vomiting and epigastric pain.