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Metabolic surgery, also referred to as bariatric surgery, has a profound effect on metabolism that greatly accelerates weight loss

The chronic nature of obesity becomes evident when people discontinue use of GLP-1s

[1] The most frequently reported adverse effects in clinical trials were gastrointestinal in nature, including nausea (12-22%), diarrhea (12-16%), vomiting (6-10%), and constipation (6-7%), with rates varying by dose

Microdosing GLP-1s isnt FDA-approved, so insurers see it as experimental. And experimental treatments are almost always excluded from coverage