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Notably, conflicting findings have been reported regarding the abundance of certain bacterial taxa (e.g., Megasphaera and Barnesiella ), potentially due to population heterogeneity, methodological variability, or confounding factors such as constipation and allergies (Averina et al., 2020

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doi: 10.3390/jcm8040488

If your employer's plan excludes anti-obesity medications entirely (common in self-insured plans), your options are: the cash-pay manufacturer programs described above, asking your HR department whether the exclusion can be reconsidered (especially if your employer is large enough to modify the plan), or using the medication under a different indication (for example, Ozempic for type 2 diabetes, if applicable)