Compounding Risks and Regulatory Oversight Challenges Both peptides appear on the FDA list of bulk drug substances that may present significant safety risks
The patient must: Be age 18 or older Have eligible Medicare Part D coverage Be prescribed treatment specifically for weight reduction and maintenance Participate in ongoing nutrition and physical activity intervention Not have already received a GLP-1 through their Part D plan Not be seeking coverage for another Part D-coverable indication, such as type 2 diabetes, moderate-to-severe obstructive sleep apnea, MASH, or cardiovascular risk reduction The patient must also have met one of these criteria when GLP-1 therapy was originally started: BMI 35 BMI 30 plus HFpEF, uncontrolled hypertension despite 2 medications, or CKD stage 3a+ BMI 27 plus prediabetes, prior MI, prior stroke, or symptomatic peripheral artery disease Important: Eligibility is based on BMI at treatment initiation, not necessarily the patients current BMI

Patients should reach out if they experience persistent nausea, vomiting, or diarrhea that prevents adequate nutrition or hydration (which may lead to dehydration and kidney problems)
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Where We Still Have Questions We dont yet know how GLP-1s might help women with: Autoimmune conditions Unexplained infertility Normal weight but recurrent fertility struggles Its tempting to imagine benefitsespecially from the anti-inflammatory effectsbut right now, the data isnt there
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