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First-Line, Second-Line, and Alternative Approaches First-Line Options: Lifestyle modification (calorie tracking, physical activity) GLP-1/GIP medications (e.g., Zepbound, Mounjaro) Second-Line: Semaglutide (Wegovy/Ozempic) Liraglutide (Saxenda) Phentermine-topiramate Alternative (or Adjunctive): Metformin (for insulin resistance/PCOS) Bupropion-naltrexone (appetite regulation) Bariatric surgery (in select patients) At Health Express Clinics, we tailor treatment based on individual metabolic profiles, access to medications, and patient goals