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FDA-approved for chronic weight management (as of April 2026): Not FDA-approved for weight loss (not covered): Metformin (approved for diabetes, used off-label for weight) Topiramate alone (approved for seizures and migraines) Bupropion alone (approved for depression and smoking cessation) Phentermine alone (approved for short-term weight loss, but most plans exclude it for long-term use) Compounded semaglutide or tirzepatide (see next section) The FDA approval line is bright and non-negotiable

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3 After propensity-score matching for age, BMI, breast density, race, ethnicity, and diabetes history (n=30,528), breast cancer occurred in 1.62% (247/15,264) of GLP-1 users over the study period of 3.5 years, compared with 2.31% (353/15,264) of matched non-users