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A careful medical review should include: Current weight, BMI, waist circumference, and body composition where available Blood pressure and cardiovascular risk factors Blood sugar, insulin resistance, A1C, and lipid markers Thyroid history and family history of certain thyroid cancers Gallbladder, pancreas, kidney, liver, and gastrointestinal history Current prescriptions, supplements, and possible drug interactions Pregnancy plans, breastfeeding status, or contraceptive considerations Prior weight loss medication experience Eating patterns, protein intake, alcohol intake, sleep, and stress This broader evaluation helps determine whether an oral weight loss pill is reasonable, whether another therapy may be safer, or whether a non-medication strategy should come first