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reinstated December 2025 (status: monitor closely) States that restrict coverage: Michigan restricted to BMI 40 (morbid obesity) with strict prior authorization criteria

It works by acting as an analog for CTLA-4, which prevents antigen-presenting cells from delivering a stimulatory signal and activating T cells, and thus reducing immune reactions

1 Inadequate protein or micronutrient intake while appetite is suppressed

We have a lot of dietary strategies to help with nausea, similar to how you would manage things like morning sickness, for example. Intense side effects and lacklustre weight loss are two reasons why patients should seek the support of registered dietitians or weight loss specialists, Casale added