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This is the minimum tier required to access GLP-1 medications

Recommended as a treatment for melasma, uneven skin tone, spots, and sun-damaged skin

Semaglutide is most effective when used as part of a medically supervised program that includes a healthy diet and regular physical activity

Starting weight loss therapy with uncontrolled hypothyroidism may: Confound assessment of treatment efficacy Complicate symptom attribution (fatigue, constipation overlap) Necessitate multiple medication adjustments simultaneously Practically speaking, patients may benefit from demonstrating stable thyroid function on consistent levothyroxine dosing before adding weight loss medications, though this is not a strict requirement

Optimal approach, albeit rarely implemented in clinical practice, would include pharmacotherapy plus an evidence-based behavioral therapy [189]

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