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**Severe Gastrointestinal Disease:** * If you already have severe stomach problems, like severe gastroparesis (slowed stomach emptying), Zepbound may make them worse and is generally not recommended

Your starting weight, metabolic rate, and prior medication history also influence the timeline

This direct-to-patient model eliminates the administrative friction that delays Zepbound access

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Additionally, most current evidence focuses on systemic RAS components, while the role of tissue-specific RAS, particularly in vascular beds, remains underexplored