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They should be carefully administered to patients with risks of hypovolemia (older age, cardiovascular diseases, treatment with diuretics, liver cirrhosis with circulatory dysfunction)

The patient is either receiving guideline-directed medical therapy (GDMT) for cardiovascular disease or has a documented clinical reason for not receiving it (such as a contraindication to lipid-lowering agents, antiplatelets, beta-blockers, or renin-angiotensin inhibitors) ( Documentation is required for approval) Continuation of therapy: The request is for continued treatment, and

ncbi.nlm.nih.gov/books/NBK499877/ Agarwal, A., Sengupta, P., & Durairajanayagam, D

Retatrutide offers a non-surgical alternative with reversibility, though long-term weight maintenance after discontinuation remains under study