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Inclusion Criteria Age 16 or older Has completed at least 6 months of structured lifestyle therapy (nutrition, activity, or behavioral support) without achieving desired results Family and teen are willing to commit to a structured program including injections, monitoring, and follow-up care BMI at or above the 95th percentile for age and gender, or above the 85th percentile with health-related conditions such as insulin resistance or high cholesterol

The most common side effects are gastrointestinal, including nausea (affecting 20-40% of users), vomiting, diarrhoea, constipation, and abdominal pain