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The American Association of Clinical Endocrinology (AACE) 2022 obesity guidelines, available at aace.com, explicitly list GLP-1 receptor agonists as second-line pharmacotherapy for patients with insulin resistance or metabolic obesity
We note that section 1833(t)(3)(F) of the Act provides that application of this subparagraph may result in the OPD fee schedule increase factor under section 1833(t)(3)(C)(iv) of the Act being less than 0.0 percent for a year and may result in OPPS payment rates being less than rates for the preceding year
They sit near the top of the evidence hierarchy, just below meta-analyses (which combine multiple RCTs)
Crucially, it does not increase insulin-like growth factor 1 (IGF-1) or cell proliferation, which has made it particularly attractive for those seeking fat loss without anabolic or mitogenic risks
Consistent with exendin-4-induced depolarization, Cork et al
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