Key Insight: The contribution to total spend on GLP-1s for members with obesity without a diabetes diagnosis has grown significantly, now constituting almost 16.5% of spend on these drugs compared to 11% in 2022 and just 4% in 2020

How to Safely Use Compounded Semaglutide Given the documented risks and recent FDA actions, patients using compounded semaglutide should take extra precautions: Essential Safety Steps: Work with your Care Team: Always obtain prescriptions from licensed healthcare providers familiar with GLP-1 medications Verify pharmacy credentials: Ensure the compounding pharmacy is state-licensed and preferably PCAB-accredited Request detailed information: Ask about ingredient sources, quality control processes, and batch testing Follow the medication guide: Carefully review all instructions for dosing and administration Monitor for adverse events: Report any unusual symptoms to your provider immediately Red Flags to Avoid: Online pharmacies advertising generic Ozempic or generic Wegovy (no generics exist) Products labeled for research purposes only Unusually low prices or no prescription required Lack of clear dosing instructions or concentration information Claims of oral tablets or nasal sprays (unproven delivery methods) Important Contraindications: Never use semaglutide if you have: Personal or family history of medullary thyroid carcinoma Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) History of diabetic retinopathy (requires monitoring) Severe kidney problems or gallbladder problems Pregnancy or planned pregnancy With the FDAs recent enforcement actions, finding legitimate sources for compounded semaglutide has become more challenging

3 A brief history of SNAC SNAC was developed in the 1990s by Emisphere (US) as part of a wider effort to identify carrier-based permeation enhancers that could chaperone candidate peptides across the gastric lining [43, 46]
Doctors will check: Blood sugar levels, usually every few months, to track how well diabetes is controlled Kidney function, especially in people with diabetes or those who may be at risk for dehydration Weight and blood pressure, to monitor progress and overall health Eye exams, especially for people with diabetes, to watch for any changes in vision Signs of pancreatitis, gallbladder problems, or allergic reactions, especially if new symptoms appear People taking other diabetes medicines may need extra monitoring for low blood sugar
Refined carbohydrates white bread, white rice, pastries, and foods with added sugar are the most problematic for abdominal fat accumulation