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Patients with a history of pancreatitis, gallbladder disease, or severe gastroparesis may require careful consideration of risks versus benefits

They may have ideas about how to get those issues under control so you can take a larger dose of semaglutide or tirzepatide

A few patterns recur often enough to address up front: borderline BMI just under a tier threshold, type 2 diabetes paired with a non-diabetes condition, prediabetes paired with a BMI above the Tier 3 range, and patients who meet more than one tier

A reasonable framework is to get a full baseline panel before you start, then recheck the markers that move