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Tirzepatide was the most cost-effective, with an incremental cost-effectiveness ratio of $34,212 per QALY gained

These plans have the potential to meaningfully affect competition in the small group market because, unlike insured plans, they use health status in rating and underwriting, and are not required to provide all of the essential health benefits that are mandatory for insured plans

Metformin may enhance weight loss by an additional 2-5% in patients with insulin resistance or elevated fasting glucose, but individual results vary

Dizziness commonly occurs through dehydration from nausea, vomiting, or diarrhoea, and may be worsened by concurrent antihypertensive medications

Methods: Hybrid methodologyan argumentative narrative review anchored by a structured evidence-mapping search (PRISMA-style flow for transparency)