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Exclusion criteria applied across all domains were: non-English language publications, case reports, and conference abstracts without full-text data

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Timeline 2: One-week washout Day 0: Last Wegovy injection Day 7-14: No injection (washout week) Day 14: First Zepbound injection Day 21: Second Zepbound injection Weeks 6, 10, 14, etc.: Dose increases per titration schedule The washout approach lets semaglutide levels drop before introducing tirzepatide

Approved medical residency program means a program that meets one of the following criteria: (i) Is approved by one of the national organizations listed in 415.152 of this chapter, provided that the national organization does not use accreditation criteria that promote or encourage discrimination on the basis of race, color, national origin, sex, age, disability, or religion, including the use of those characteristics or intentional proxies for those characteristics as a selection criterion for employment, program participation, resource allocation, or similar activities, opportunities, or benefits

Storage conditions Store in a cool, dry place and away from sunlight