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Others explicitly exclude it to keep premiums down

The design makes it easy to hide it under any clothing

Considering the retrospective design, certain data points are lacking, as they were originally documented for clinical monitoring purposes rather than for the explicit intent of this study

Some research suggests they may be particularly helpful for women with other hormonal issues, including insulin resistance and polycystic ovarian syndrome (PCOS)

Once-weekly glucagon-like peptide-1 receptor agonist dulaglutide is non-inferior to once-daily liraglutide and superior to placebo in Japanese patients with type 2 diabetes: a 26-week randomized phase III study

If you ignore one, the other two will suffer. References Cleveland Clinic