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While these findings are not established in MASH models, they provide a mechanistic basis for hypothesizing that these immunometabolic alterations are relevant to obesity-associated liver disease

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This isnt theoretical we see it clinically

States with restrictions: Arkansas, Louisiana: Require in-person visit before prescribing controlled substances or weight-management medications (tirzepatide is not controlled, but some providers interpret regulations conservatively) Texas: Requires Texas-licensed provider for prescriptions filled at Texas pharmacies California: Allows telehealth prescribing but requires ongoing relationship (not one-time consultation) Compounding pharmacy restrictions: Some states restrict out-of-state compounding pharmacies from shipping into the state