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Common requirements include documented BMI meeting the threshold, proof of previous weight loss attempts (usually 3-6 months of supervised diet and exercise), at least one qualifying comorbidity, and sometimes evidence that other treatments have been tried and failed

Prescription Medications: Prescription provided only if clinically appropriate

PMID 2604726

Melanosis of the duodenum is a rare finding and has been attributed to a number of causes like chronic kidney disease, gastrointestinal bleeding, and folic acid deficiency

Unless you have a compelling deadline or demonstrated GLP-1 tolerance, the standard protocol produces better long-term adherence and similar 48-week outcomes