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In type 2 diabetes populations across 38 phase III/IV trials, the rate was lower at 19.3% versus 6.5% on placebo

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The body has adapted to the medication, GI side effects have resolved, hormonal levels have reached a new baseline, and the brain reward system has partially recalibrated

(PubMed) Matthews A, Dowswell T, Haas DM, Doyle M, O'Mathuna DP

The status of these substances in sport, nor whether an athlete has a medical exemption, has no bearing on how customs and immigration laws are enforced in specific countries