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I found on GoodRx.com and another cash pay website that they can actually offer some of those first line medications like Wegovy and semiglutide for 99 dollars to 129 dollars per month at a cash rate

Uncontrolled hypothyroidism should be addressed first, as inadequate thyroid hormone replacement can contribute to weight gain and may complicate the assessment of Wegovy's effectiveness

Dopamine, tyramine, and tryptamine are metabolized by both MAO-A and MAO-B

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Any interaction with GABAergic agents, benzodiazepines, or other sedatives is unstudied and theoretically could produce additive CNS depression

Comparison: Studies comparing GLP-1RA therapy to placebo, no GLP-1RA, or other active comparators (e.g., DPP-4 inhibitors)