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One explanation is that the side effects are often harrowing

Meals became stress instead of joy, weighed down by nausea, food aversions, and the guilt of wasted food

Lancet 383(9918):736747 [DOI] [PMC free article] [PubMed] [Google Scholar] 18.Somers VK, White DP, Amin R, Abraham WT, Costa F, Culebras A (2008) Sleep apnea and cardiovascular disease: An American Heart Association/American College of Cardiology Foundation Scientific Statement

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Over time, this can increase the risk of lean tissue breakdown