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Phentermine is not licensed for use in the UK and is not available on the NHS or through registered UK pharmacies

All medical spas are required to have a supervising licensed physician, according to the Texas Medical Board

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Drug Interactions and Compatibility 9.1 Interaction with Insulin and Oral Antidiabetics Concomitant use may require dose adjustments to prevent hypoglycemia

Gln 24 Substituting GLP-1 Ala 30 with Gln decreases the affinity (IC 50 : 0.27 nM1.4 nM) but increases activity (EC 50 : 2.6 nM0.5 nM)

Ask for the denial reason in writing, request a peer-to-peer review, and resubmit with missing documentation