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At present, there is a balance payers must achieve across a variety of influencing factors on whether to cover GLP-1s (see Figure 1)

Dam, Tine Vrist, et al

Other contributing factors include: Small intestinal bacterial overgrowth (SIBO) Gastrointestinal infections or parasites Certain medicines that slow digestion (e.g., opioids, anticholinergics, tricyclic antidepressants, GLP-1 receptor agonists) Food intolerances or malabsorption disorders Swallowing excess air (aerophagia) Consumption of carbonated beverages Understanding the underlying cause is essential for effective management