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Because people often switch jobs and health insurers, there isnt always an incentive to pay upfront for a drug that may generate health benefits and cost reductions in the future, said Larry Levitt, executive vice president at the health policy think tank KFF

Insulin resistance, a common characteristic of obesity, can also influence dosage decisions, particularly with GLP-1 agonists, as they directly impact insulin secretion and sensitivity

There is also emerging data suggesting that GLP-1 tolerability and efficacy vary with the hormonal cycle, and that higher circulating estrogen levels are associated with increased nausea and vomiting on these medications

Visvabharathy V et al