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8 editorial guides covering on-label and emerging uses. Evidence summary, prescribing reality, and insurance pathway for each indication.
Zepbound is the only FDA-approved GLP-1 for OSA with obesity (December 2024). The OSA pathway is currently the cleanest route to weight-loss GLP-1 coverage for many insurance plans.
Semaglutide reduces kidney disease progression in T2D patients with CKD. FLOW trial (2024) supports broader use. Mounjaro shows similar signals.
Wegovy is FDA-approved for cardiovascular risk reduction in adults with established cardiovascular disease and BMI ≥ 27. The 2026 Medicare cardiovascular pathway opens coverage.
GLP-1s slow gastric emptying intentionally. Patients with preexisting gastroparesis or significant motility disorders should not use GLP-1s. Anesthesia preoperative protocols increasingly require GLP-1 hold.
PCOS is the most-asked off-label GLP-1 indication. Weight loss, insulin sensitivity, and androgen levels often improve, but FDA approval is not on-label.
MASLD/MASH is the next major GLP-1 expansion. Semaglutide showed Phase 3 efficacy in resolving steatohepatitis without worsening fibrosis. FDA approval expected 2026-2027.
No GLP-1 is FDA-approved for prediabetes, but trials show 60-70% reduction in T2D progression at 3 years. The case for early intervention is strong.
Menopause-driven weight gain responds to GLP-1s similarly to other adult obesity. No menopause-specific indication exists, but real-world data show comparable efficacy.