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The transition to menopause which typically begins in a womans mid-to-late 40s and can span several years brings a significant drop in estrogen

Patients with certain health issues might need their doses adjusted to avoid problems

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Other conditions worth considering include: Type 2 diabetes or pre-diabetes , where insulin resistance affects how the body processes and stores energy Cushing's syndrome , caused by excess cortisol, which promotes central weight gain Perimenopause and menopause , which are associated with hormonal changes that can affect body composition and fat distribution Obstructive sleep apnoea (OSA) , which disrupts sleep quality and is associated with weight gain and metabolic changes Depression and anxiety , which can affect appetite regulation, sleep, and motivation Heart, kidney, or liver conditions , which can cause fluid retention and apparent weight gain Certain medicines , including corticosteroids, some antidepressants (such as mirtazapine), some antipsychotics, insulin, sulfonylureas, pioglitazone, valproate, and some gabapentinoids, which may promote weight gain as a side effect

They purchase the raw API and manufacture injectable solutions or sometimes oral drops/pills