doi:10.1155/2017/1617458 21
The relevant question isnt why does this cost more than the nurse clinic but whats the value of having a plastic surgeon do this rather than a nurse

These shifts correlated with improvements in metabolic parameters, notably, reduced body weight and improved dyslipidemia (lowered LDL-C and total cholesterol), suggesting that modulation of the gut microbiota is one mechanism by which GLP-1 RAs confer metabolic benefits and lipid-lowering effect ( Bacillota and Bacteroidota alters the pool of intestinal metabolites, in particular by increasing taurocholic acid, which in turn stimulates the release of GLP-1 from L cells, improving glucose tolerance ( Bacteroides , members of the family Lachnospiraceae , and the beneficial genus Bifidobacterium , which was linked to lowered intestinal inflammation and improved glycemic control ( Romboutsia, Ruminiclostridium , and Erysipelotrichaceae ) and enriching lean mass-related genera (e.g., Prevotella ), with an increase in the Bacteroidota - Bacillota ratio and a clear correlation between microbial changes and metabolic parameters

Saxenda is one of the GLP-1 medications prescribed by Calibrate clinicians