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A provider letter explaining "this patient really needs Wegovy because they have failed multiple diets" does not override the step therapy requirement

Working within the system to deliver improved care We are fortunate to have evidence on numerous effective interventions in type 2 diabetes, but translating this evidence into practice cannot rest only with front-line clinicians during individual clinic visits

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Understanding this mechanism helps clarify why most individuals without a gallbladder tolerate GLP-1 therapy well, though personalization remains important

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This includes cigarettes, but also vaping, and marijuana