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This turns the fasting period into productive time rather than idle waiting

That growth can compress the urethra and affect urination

When pain becomes a diagnosis instead of a signal, true healing is delayed

Never simultaneously

Expert consensus suggests considering pharmacotherapy when there is: Significant weight regain from nadir weight BMI 27 kg/m with obesity-related comorbidities or BMI 30 kg/m Absence of anatomical complications requiring surgical revision Adequate adherence to nutritional and behavioral recommendations Patient willingness to engage in long-term pharmacotherapy The American Association of Clinical Endocrinologists (AACE) and American College of Endocrinology (ACE) guidelines emphasize that pharmacologic therapy should complement, not replace, lifestyle interventions and ongoing bariatric surgical follow-up