The study published in the JAMA Network Open cited cost as the likely reason, with side effects also mentioned

Tailored for bariatric and GLP-1 patients: Designed to support hormone balance and estrogen metabolism in easy-to-swallow caplets, formulated to avoid dose-dumping and support gentle absorption* Bariatric must haves: Contains a unique blend of DIM, NAC and chasteberry extract, 3 powerful ingredients carefully selected for their ability to promote hormonal balance for women and support the unique needs of bariatric patients* Hormonal balance for women: DIM supports the metabolism of estrogen, while chasteberry may help ease the most common symptoms associated with the menstrual cycle and NAC provides antioxidant support to protect cells from oxidative stress* Formulated with you in mind: Our small, smooth-coated caplets are titanium-dioxide free, talc free, no artificial colors, dairy-free, and gluten-free and is designed to be gently absorbed without the stomach discomfort you may experience from other pills Committed to quality and care: Barimelts bariatric vitamins and supplements are produced in our NSF-certified GMP facility, and undergo third-party testing for potency and purity

Some people may experience small amounts of food or liquid coming back up
Patients reach Strive Pharmacy through telehealth platforms like Lavender Sky Health, direct provider prescriptions, and various telemedicine services that partner with compounding pharmacies
But Saxenda had drawbacks
Researchers are examining its known ability to improve the way we help people who face chronic weight management