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If youve tried everything else listed here then consider adding a GLP-1 agonist but only for a short period of time (no more than 1 year)

& Madsbad, S

Tanaka, Y., Iwaya, C., Kawanami, T., Hamaguchi, Y., Horikawa, T., Shigeoka, T., Yanase, T., Kawanami, D., & Nomiyama, T

LDL-C, low density lipoprotein cholesterol

This screening is essential because GLP-1 medications affect appetite signaling and glucose metabolism system-wide, and individual tolerability varies significantly based on metabolic state and underlying conditions

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