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Zepbound sits on Cigna's national formularies (it's even listed as a preferred alternative for people coming off Saxenda), and the current policy grants an 8-month initial approval when you meet the BMI and lifestyle criteria below

Ideally, the targeted receptor- or carrier-mediated transport processes for brain targeting should occur exclusively at the BBB to avoid off-target delivery

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Using his own protocol, which includes methylation cycle treatment (but does not include 5-Methyltetrahydrafolate) Dr Enlander reports he has 112 patients under treatment and 65% to 70% show improvement. Derek Enlander M.D NYC

Med Sci Sports Exercise 31: 1108-1110