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Recognizing obesity as a metabolic condition with hormonal componentsnot simply a behavioral oneopens new treatment pathways

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GSM-directed therapy in peri/postmenopausal patients (or others with hypo-oestrogen states): NICE and UK resources support vaginal oestrogen as a local therapy for genitourinary symptoms of menopause, with patient counselling that systemic absorption is minimal and serious adverse effects are very rare

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Insurance coverage exists but requires prior authorization, BMI thresholds, and documented comorbiditiesbarriers that exclude millions of eligible candidates