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The takeaway: if you are planning to request Wegovy through Express Scripts, ask your provider to prescribe a 90-day course of orlistat first, document your weight at the start and end of the 90 days, and submit the Wegovy prior authorization after the orlistat trial
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Upper endoscopy or contrast studies may be indicated if anatomical issues such as gastrojejunal anastomosis dilation are suspected, as these may require surgical revision rather than or in addition to pharmacotherapy
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