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Orlistat may interact with warfarin and can reduce the absorption of fat-soluble vitamins, so supplementation may be necessary

Protein is non-negotiable GLP-1 agonists cause weight loss through multiple mechanisms, but not all weight loss is equal

If your insurance plan denies coverage, we will recommend self-pay options: Zepbound from Lilly Direct: $349/month for 2.5mg dose $499/month for 5.0mg (and higher doses when refilled within 45 days) Medication is sent in vials along with syringes/supplies Wegovy from NovoCare: $499/month (any dose) Medication is an autoinjector (no syringes/needles needed) You may use your insurance for follow up medical visits with your provider (or self-pay $100)

Starting conservatively respects individual variation and often reduces unwanted gastrointestinal effects

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The trade-off is co-stimulation of cortisol and prolactin that ipamorelin largely avoids