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Key Sources and Documentation California Department of Managed Health Care DMHC Enforcement Actions and Penalties Independent Medical Review (IMR) Decisions and Consumer Guidance Blue Shield of California Policy Documents Weight Management Agents: Medical Policy (Blue Shield of California) Prescription Coverage Policies and Prior Authorization Requirements Litigation and Denial Practices Gianelli & Morris Cases Against Blue Shield of California (Utilization and Denial Practices) GLP-1 Medications and Obesity Care FDA Approval of Zepbound (tirzepatide) for Chronic Weight Management American Medical Association: Obesity as a Chronic Disease

- Pregnancy and breast-feeding: As there is no established safety data for MOTS-c use during pregnancy or breast-feeding, it should be avoided

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The different mechanisms by which the lumen and perfused tubes form are termed type I and type II anastomosis, reviewed in detail by Betz et al