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Clinical judgment that matters: We take contraindications seriously and screen for issues that change the plan, including: Personal/family history concerns related to medullary thyroid carcinoma or MEN2 History of pancreatitis or significant gallbladder disease (risk evaluation matters) Severe reflux/gastroparesis-like symptoms (may worsen) Pregnancy planning (weight-loss meds are not the right tool in that window) If youre not being screened, youre not being managed