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Healthline notes that prescriptions typically require a BMI of 30 or higher, but the evaluation goes beyond just one number

Prior authorization for medication is a coverage approval process in which a healthcare provider must obtain insurance company approval before prescribing certain medications

Some people carry genetic variants that affect how their bodies respond to GLP-1 receptor activation

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In one published case, an active, lean-adjacent man lost about one-third of his total weight as muscle on 2.5 mg and recovered it after adding resistance training and increasing protein. This is a cautionary case, not an incidence estimate