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When medication is appropriate, the discussion should include: The limited evidence for GLP-1 agonists specifically in BED FDA-approved alternatives, including lisdexamfetamine Realistic expectations about outcomes and timeline Potential side effects and monitoring requirements Cost considerations and insurance coverage The importance of combining medication with behavioral interventions Monitoring during treatment should be systematic and multifaceted

GLP-1 medications reduce thirst signaling alongside hunger signaling, so many patients are already running mildly dehydrated before adding a diuretic on top

As an example, Zepbound (tirzepatide), is approved by the FDA for chronic weight management in adults with obesity (BMI of 30 kg/m2 or greater) or overweight (BMI of 27 kg/m2 or greater) with at least one weight-related condition, which can include conditions other than type 2 diabetes

These are also the most expensive, which is a primary factor in states' coverage decisions

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There are various reports of it being used for anti-aging purposes with the rationale that the aging process involves damage from free radicals and glutathione neutralizes the toxins and promotes healing and repair