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Olympia Pharmaceuticals, Empower, and dozens of other compounding pharmacies operated under this shortage designation

Nasal spray delivery offers an appealing alternative, allowing peptides to absorb through nasal mucosa directly into systemic circulation while bypassing first-pass liver metabolism that destroys orally-administered peptides

Cost is another factor to consider

Ideal candidates might include those who: Have documented binge eating episodes causing significant distress Meet BMI criteria for weight management medications Have not responded adequately to psychological interventions (such as cognitive behavioural therapy) Do not have contraindications to GLP-1 therapy Understand the off-label nature of this indication UK SmPCs for GLP-1 medications note findings of thyroid C-cell tumours in rodent studies, though the relevance to humans remains uncertain

with congestive heart failure New York Heart Association (NYHA) class IV

Additional studies are needed to determine if men who are more obese at baseline have a higher risk of developing OSA with TTh than nonobese men