For nearly two years Nicole Cowart’s doctor recommended she take a glucagon-like peptide-1 (GLP-1) receptor agonist. The doctor said it would help her manage her prediabetes and leg swelling—but her insurance wouldn’t pay unless she was diagnosed with type 2 diabetes.

Cowart ran out of treatment options and remembers her doctor hoping that she would develop diabetes so she could qualify for insurance coverage for the drug. “This is not the way it’s supposed to be, where you’re sort of hoping that you have diabetes so you can get this medication to lose weight,” says Cowart.

More recently she overheard a woman in her dentist’s waiting room talking about her new prescription for tirzepatide (Mounjaro, Zepbound), a glucose dependent insulinotropic polypeptide receptor and GLP-1 receptor ago

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