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If cost is the primary factor, start with semaglutide through MEDVi
On a 40-pound weight loss, that is the difference between losing 4-8 pounds of lean mass versus 14-16 pounds
Warning letters are also not findings of guilt - the FDA's own Regulatory Procedures Manual describes them as informal and advisory communications that give companies the opportunity to correct identified issues

Pharmacologic Treatment of Overweight and Obesity in Adults

But "better in a trial" and "better for your specific body" are two very different things