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This is not a dilution strategy

Anecdotal evidence is emerging on the plausible contribution of GLP-1 RAs to unplanned pregnancies by regularizing ovulation in subjects with obesity and polycystic ovarian syndrome
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This single case does not establish causation, but it raises a flag that clinicians should be aware of, particularly in patients with pre-existing SLE or lupus-like features

Bariatric surgery + GLP-1 If youve had a malabsorptive bariatric surgery (like a Roux-en-Y gastric bypass or biliopancreatic diversion), birth control pill absorption is already reduced by the surgery