Medical Glossary

5-Amino-1MQ is a small-molecule inhibitor of the enzyme nicotinamide N-methyltransferase (NNMT), not a peptide, sold online as a research chemical for weight loss.

503A compounding pharmacy is a state-licensed pharmacy where a pharmacist or physician prepares a drug for a specific, identified patient based on a valid prescription.

503B outsourcing facility is a drug compounder registered with FDA that operates under manufacturing-quality rules, without needing a prescription for each named patient before compounding.

A1C is a blood test that measures your average blood glucose level over the past 3 months, based on glucose attaching to hemoglobin in red blood cells.

AHK-Cu is a copper-binding tripeptide, L-alanyl-L-histidyl-L-lysine-Cu2+, studied for stimulating hair follicle growth in laboratory experiments.

AICAR is a small-molecule activator of an enzyme called AMPK, not a peptide, studied as a research compound for exercise metabolism.

Anti-obesity medication refers to prescription drugs used, along with diet and physical activity, to treat obesity, or overweight together with a weight-related health condition.

AOD-9604 is not FDA-approved, and its 503A compounding nomination was withdrawn after FDA raised safety concerns.

Appeal refers to a request to your health insurer or the Health Insurance Marketplace to review a decision that denied a benefit or payment.

ARA-290 is a nonhematopoietic peptide designed from the structure of erythropoietin that interacts with the innate repair receptor, rather than the receptor that makes red blood cells.

Asynchronous visit refers to a telehealth visit in which medical information is transmitted and reviewed at a later time, outside a real-time or live interaction.

B12 + MIC is an injection that combines vitamin B12 with methionine, inositol and choline, marketed for weight loss and energy under names like the skinny shot.

Bacteriostatic water is sterile water containing 0.9% or 1.1% benzyl alcohol as a preservative, used only as a diluent for other injectable drugs.

Basal metabolic rate is the energy the body uses at complete rest to keep basic functions running, the largest component of daily energy demand in Western societies.

Best GLP-1 for weight loss is a question the trial data can only partly answer.

Bioidentical hormones are hormones chemically identical to those the body makes, sold either as FDA-approved drugs or as compounded products marketed under the bioidentical label.

Biological age is an estimate of how old the body appears based on molecular or physiological markers, rather than years since birth.

Black box warning is a warning FDA can require to be set inside a box on a prescription drug's label, under an uppercase heading with the word WARNING.

BMI (body mass index) is a measurement that uses weight and height to estimate overweight and obesity, calculated as weight in kilograms divided by height in meters squared.

Board certification is a credential showing a physician or nurse practitioner has met a certifying board's standards, separate from a license to practice.

Body composition refers to the proportions of fat, muscle, bone, and other tissue that make up a person's body weight.

BPC-157 (Body Protection Compound-157) is a synthetic peptide of 15 amino acids derived from a fragment of a gastric protein.

Brand-name vs generic refers to two ways the same active ingredient can reach the market: under a manufacturer's trademarked name, or, once patents and exclusivity expire, as an FDA-approved generic.

CagriSema is an investigational once-weekly combination of the amylin analog cagrilintide and the GLP-1 medicine semaglutide, dosed together at 2.4 mg each.

Caloric deficit is a state in which the body uses more calories than it takes in from food and beverages.

Cash pay is paying the full price of a medication yourself, without using insurance to cover any part of the cost.

Cash price of GLP-1s refers to what Zepbound and Wegovy cost when paid out of pocket through the manufacturer's own self-pay channel, rather than through insurance.

Category 1 vs Category 2 peptides refers to FDA's interim sorting of substances nominated for the 503A bulks list.

Certificate of analysis is a supplier's test report stating a batch's identity, purity and other quality measures.

CJC-1295 is a long-acting analog of growth hormone-releasing hormone (GHRH) studied in two 2006 randomized trials for its ability to raise growth hormone and IGF-1 levels.

Coinsurance is the percentage of a covered service's cost you pay, such as 20%, after you've met your deductible.

Cold chain shipping is a chain of temperature-controlled storage and transport steps that keeps a temperature-sensitive product within its required range.

Comorbidity is the condition of having two or more diseases at the same time.

compounded peptide is a peptide medication custom-mixed by a compounding pharmacy for an individual patient rather than manufactured by an FDA-approved drug maker.

Compounded semaglutide is a custom-mixed version of the GLP-1 drug semaglutide made by a licensed pharmacy rather than a drug manufacturer.

Compounded tirzepatide is a custom-mixed version of the GLP-1/GIP drug tirzepatide made by a compounding pharmacy rather than a drug manufacturer.

Compounding pharmacy is an umbrella term for a pharmacy or facility that combines, mixes, or alters ingredients into a drug tailored to a patient's needs.

Continuity of care is the process by which a patient and their physician-led care team work together over time toward safe, high-quality, cost-effective medical care.

Contraindication is a reason not to give a specific treatment because it could cause harm.

Copay is a fixed dollar amount, such as $20, that you pay for a covered service or prescription after you've met your deductible.

Coverage exclusion is a service or drug your health plan's terms say it will not pay for or cover.

Deductible is the amount you pay for covered health care services before your insurance plan starts to pay.

Dihexa is a synthetic angiotensin IV-based compound studied in animals for memory and synaptic effects, developed as a blood-brain-barrier-permeable analog by a Washington State research group.

DSIP is a nonapeptide first isolated from rabbit cerebral venous blood in 1977 and studied for insomnia, with the sequence Trp-Ala-Gly-Gly-Asp-Ala-Ser-Gly-Glu.

Dual agonist refers to a medicine engineered to activate two separate hormone receptors, usually GIP and GLP-1, at once in a single molecule.

Dulaglutide is the active ingredient in Trulicity, a once-weekly GLP-1 receptor agonist injection.

Epitalon is a synthetic tetrapeptide (Ala-Glu-Asp-Gly) developed from epithalamin, a pineal extract studied by Russian researcher Vladimir Khavinson.

FDA bulk drug substances list refers to FDA's lists of active ingredients nominated for use in compounding, sorted into review categories that determine eligibility.

FDA drug shortage list is a public database of drugs FDA has determined are in shortage in the United States, updated daily with new and resolved shortages.

Follistatin-344 is an isoform of a myostatin-binding protein sold online as an unapproved bodybuilding injectable, prohibited in sport as a myostatin inhibitor.

Food noise is an informal term for a preoccupation with food that can feel persistent, intrusive, and unwanted, not a medical diagnosis.

Formulary is the list of prescription drugs a health plan covers, also called a drug list.

Foundayo is the FDA-approved brand name for orforglipron, an oral GLP-1 receptor agonist tablet, approved April 1, 2026 to reduce excess body weight and keep it off.

FSA is an arrangement through your employer that lets you pay for many out-of-pocket medical expenses with tax-free dollars.

Gastric emptying is the process by which the stomach releases its contents into the small intestine after a meal.

Gastroparesis is a disorder that slows or stops food from moving from the stomach to the small intestine, also called delayed gastric emptying.

GHK-Cu is a copper-bound tripeptide, glycyl-L-histidyl-L-lysine, found naturally in the body.

GHRP-2 / GHRP-6 are synthetic growth hormone-releasing peptides with no structural homology to GHRH, developed to stimulate the body's own growth-hormone release.

GIP is a 42-amino-acid hormone released from intestinal K cells that stimulates insulin release after eating.

GLP-1 (glucagon-like peptide-1) is a hormone your gut releases after you eat.

GLP-1 alternatives are FDA-approved weight-management medications that do not act on the GLP-1 receptor, plus non-drug approaches.

GLP-1 cost refers to what a patient or payer spends on drugs like Ozempic, Wegovy, Mounjaro, and Zepbound, which varies by list price, Medicare-negotiated price, self-pay offer, and insurance coverage.

GLP-1 injections are once-weekly subcutaneous shots, such as Zepbound and Mounjaro, that deliver a GLP-1 or dual GIP/GLP-1 medication under the skin.

GLP-1 medications list refers to the FDA-approved GLP-1 and dual GIP/GLP-1 brands covered here: Wegovy, Ozempic, Rybelsus, Zepbound, Mounjaro and Foundayo.

GLP-1 receptor agonist is a medication that activates the GLP-1 receptor.

GLP-2 is a gut hormone released from intestinal L cells that promotes intestinal growth, absorption and blood flow, distinct from GLP-1, the hormone targeted by weight-loss drugs.

Glutathione is a tripeptide of glutamate, cysteine and glycine made in the body.

Glutathione injection is a compounded IV or IM product containing the antioxidant tripeptide glutathione, prepared by a 503A pharmacy from bulk glutathione powder.

Growth hormone peptides is an umbrella term for GHRH analogs and GH-releasing peptides marketed to raise the body's own growth-hormone output, including tesamorelin, sermorelin, CJC-1295, ipamorelin and GHRP compounds.

Growth hormone releasing hormone is a 44-amino-acid hypothalamic peptide, first isolated in 1982 from a human pancreatic tumor, that stimulates the pituitary to release growth hormone.

Growth hormone secretagogue refers to any compound that prompts the pituitary gland to release growth hormone, grouped under an umbrella that includes GHRH analogs and GH-releasing peptides.

Half-life is the time it takes for the amount of a drug in the body to fall by half.

Healthspan is the portion of life spent free of significant disease or disability, as distinct from lifespan.

HPLC purity is the share of a chromatography signal attributed to the target peptide, measured against everything else the method detects, such as impurities, degradation products and aggregates.

HSA is a savings account that lets you set aside money on a pre-tax basis to pay for qualified medical expenses.

Humanin is a short mitochondrial-derived peptide first identified in 2001 that protects cells from stress-induced death in laboratory studies.

IGF-1 LR3 is a modified, longer-acting analog of insulin-like growth factor 1 sold online as a research peptide.

Incretin refers to a class of gut hormones, GIP and GLP-1, that boost insulin release after eating more than glucose alone would trigger.

Informed consent is the process by which health care providers explain a patient's health condition and treatment choices, so the patient can decide whether to accept care.

Injectable peptides are peptide drugs delivered by subcutaneous or intramuscular injection, the route used by many approved peptide medications.

Insulin resistance is a condition in which the body's cells do not respond to insulin the way they should.

Intake form refers to the document a patient fills out to record their medical history, including allergies, illnesses, surgeries, medicines, and health habits, before or at the start of care.

Ipamorelin is a synthetic pentapeptide that stimulates the pituitary to release growth hormone, acting as a relatively selective agonist of the GHSR-1a receptor.

Kisspeptin is a naturally occurring hormone that triggers GnRH release through the GPR54 receptor and drives puberty and reproductive hormone signaling.

KPV is a tripeptide of lysine, proline and valine derived from alpha-MSH(11-13) and studied for wound healing and inflammation in mice.

Lean body mass is the weight of everything in the body other than fat, including muscle, organs, bone, and fluid.

LegitScript certification is a compliance certification that pharmacies, telemedicine providers and other healthcare merchants can earn from LegitScript.

Letter of medical necessity is a statement from your prescriber explaining why a specific drug is medically necessary for you.

LillyDirect is Eli Lilly's direct-to-consumer healthcare platform, offering home delivery and telehealth options for Lilly medications.

Lipid panel is a blood test, also called a lipoprotein panel or lipid profile, that measures LDL and HDL cholesterol and triglycerides.

Lipotropic injection is a shot marketed as lipotropic, or fat-mobilizing, typically combining methionine, inositol and choline with a B vitamin, sold under names such as the lipo shot.

Liraglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist sold as two FDA-approved brand-name injections: Victoza, for type 2 diabetes, and Saxenda, for chronic weight management.

LL-37 is a 37-residue antimicrobial peptide made only by humans, released from the precursor protein hCAP-18 by neutrophils.

Longevity peptides is an umbrella term for amino-acid chain compounds studied or marketed in connection with aging and lifespan.

Lyophilized peptide refers to a peptide that has been freeze-dried into a stable powder by removing water under vacuum after freezing.

Maintenance dose is the dose a patient stays on once dose escalation is complete, chosen from the range listed on the drug's label.

Manufacturer savings card is a discount offered directly by a drug maker to lower the out-of-pocket cost for patients with commercial insurance or who pay without insurance.

MASLD is excess fat buildup in the liver, not caused by heavy alcohol use, in a person with at least one cardiometabolic risk factor.

Medicaid coverage is the extent to which a state Medicaid program pays for GLP-1 medications, which varies because weight-loss drugs are optional while diabetes drugs are mandatory.

Medicare Part D is the Medicare prescription drug benefit that has historically excluded GLP-1 medications used only for weight loss.

Medullary thyroid carcinoma is a cancer that develops in the thyroid's C cells, the cells that make the hormone calcitonin.

Melanotan II is a synthetic peptide analog of melanocyte-stimulating hormone marketed online as an injectable or nasal-spray tanning product.

Membership fee is the recurring charge a telehealth program bills for provider consultations, messaging, and platform access, separate from any medication cost.

Metabolic panel refers to a routine blood test, most often a comprehensive metabolic panel (CMP), that measures substances such as glucose, electrolytes, and kidney and liver markers.

Metabolic syndrome is a group of conditions that together raise the risk of coronary heart disease, diabetes, stroke, and other serious health problems.

Metformin for longevity refers to using metformin, a biguanide FDA-approved only for type 2 diabetes, off-label in hopes of slowing aging.

mg vs mcg dosing refers to the difference between milligrams and micrograms, a factor of 1,000, in how peptide product strengths are labeled.

Microdosing GLP-1 refers to taking smaller-than-labeled doses of a GLP-1 medication, for example from multidose pens or compounded vials, outside the prescribed schedule.

Mitochondrial health is a research and marketing phrase for how well mitochondria, the cell structures that convert nutrients into usable energy, are functioning, not a standardized clinical diagnosis.

Most-favored-nation pricing refers to a policy aiming to bring American drug prices in line with those paid by similar nations.

MOTS-c is a 16-amino-acid peptide encoded by a short open reading frame within mitochondrial DNA.

Mounjaro is a brand-name tirzepatide injection FDA-approved to improve blood sugar control in adults and children 10 and older with type 2 diabetes.

NAD+ is a coenzyme found in every cell that helps transfer energy from food into a usable form, and is chemically a dinucleotide rather than a peptide.

NAD+ and resveratrol refers to pairing an NAD+-boosting supplement or injection with resveratrol, a plant compound studied as an activator of sirtuin enzymes that require NAD+ to function.

NAD+ injection is a compounded product delivering the coenzyme nicotinamide adenine dinucleotide by IV or subcutaneous injection, marketed for anti-aging and wellness uses.

Natural GLP-1 boosters are foods and supplements marketed to raise your own GLP-1 hormone.

Newest GLP-1 medications refers to the most recently approved and the still-pending drugs in the GLP-1 class.

Nootropic peptides refers to peptides marketed for cognitive or mood effects, including Semax, Selank, dihexa and P21, none of which is FDA-approved.

NovoCare Pharmacy is the pharmacy service Novo Nordisk operates to deliver GLP-1 medications directly to patients, with self-pay pricing that does not require insurance.

Nurse practitioner (NP) is a nurse with a graduate degree in advanced practice nursing who can take a patient's history, diagnose and treat disease, and prescribe medicines.

Obesity is a common, chronic disease marked by an abnormally high, unhealthy amount of body fat, generally defined in adults as a BMI of 30 or higher.

Obstructive sleep apnea is a condition in which the upper airway becomes blocked many times during sleep, reducing or completely stopping airflow.

Off-label use is prescribing an FDA-approved drug in a way its label does not cover: for a different disease, in a different way, or at a different dose than approved.

Oral GLP-1 medications are pill or tablet forms of GLP-1 receptor agonist drugs, taken by mouth instead of injected.

Orforglipron is a GLP-1 receptor agonist taken as a once-daily oral tablet, rather than an injection, that binds to and activates the human GLP-1 receptor.

Out-of-pocket maximum is the most you have to pay for covered services in a plan year before your health plan starts covering 100% of the costs of covered benefits.

Oxytocin nasal spray is a nasal form of the nonapeptide hormone oxytocin, which FDA has approved only as an injection (Pitocin) for labor-related use.

Ozempic is an FDA-approved weekly semaglutide injection indicated for adults with type 2 diabetes, used alongside diet and exercise to improve blood sugar control.

Ozempic face is an informal term for the deflated, prematurely aged look some people notice in their face after rapid weight loss, not a medical diagnosis.

P21 is the common name for P021, a small neurotrophic peptide mimetic developed to overcome the drug-delivery problems of natural neurotrophic factor proteins.

Pancreatitis is inflammation of the pancreas, the organ that makes insulin and digestive enzymes.

Patient assistance program is a program, usually run by a drug's manufacturer, that provides medicine at no cost to patients who meet its eligibility rules, typically insurance status and income.

PCAC, the Pharmacy Compounding Advisory Committee, is the FDA committee that advises on drug compounding under sections 503A and 503B, with a core of 12 voting members.

PCOS (polycystic ovary syndrome) is a set of symptoms related to a hormonal imbalance.

PEG-MGF is the pegylated form of mechano growth factor, a splice variant of IGF-1 the body produces after resistance exercise.

Pen injector is a prefilled device used to inject GLP-1 medications subcutaneously, either as a single-dose pen used once and discarded or a multi-dose pen reused for several doses.

Peptide is a short chain of amino acids, which FDA defines as 40 or fewer.

Peptide cycling is forum vocabulary for stopping and restarting an unapproved peptide on a schedule.

Peptide reconstitution is the process of adding a sterile liquid diluent to a freeze-dried peptide powder to prepare it for injection.

Peptide side effects are the adverse reactions reported for both FDA-approved peptide drugs and unapproved compounded peptides.

Peptide stack is informal slang for combining two or more peptides in one regimen, most often growth hormone secretagogues or tissue-repair peptides, without any FDA review of the combination.

Peptide therapy is the use of amino-acid chain compounds for medical or performance purposes, spanning FDA-approved medications and unapproved compounded or research-grade peptides sold directly to patients.

Peptides for healing refers to peptides marketed for tissue repair and recovery, most often BPC-157, TB-500, GHK-Cu and KPV, none of which is FDA-approved for that use.

Peptides for muscle growth refers to growth-hormone secretagogues, IGF-1 LR3, follistatin and MGF, marketed online to increase lean mass.

Peptides for sleep refers to a small group of peptides marketed for insomnia, chiefly DSIP and epitalon, neither backed by strong human evidence.

Peptides for testosterone refers to peptide hormones and peptide-based medicines that can influence testosterone production through the hypothalamic-pituitary-gonadal (HPG) axis.

Peptides for weight loss refers to a mix of two FDA-approved peptide drugs and several unapproved peptides marketed online for fat loss.

Pharmacy benefit manager is a company that negotiates drug rebates with manufacturers, builds the formulary and its rules, and reimburses pharmacies for a health plan's prescription claims.

Pinealon is a synthetic tripeptide, Glu-Asp-Arg, developed by Russian peptide researchers and studied mainly in rats.

Polypeptide is the general chemistry term for a chain of amino acids joined by peptide bonds, with no fixed length limit.

Prediabetes is a condition in which blood glucose levels are higher than normal but not high enough to be diagnosed as type 2 diabetes.

Prior authorization is approval your health plan requires before it will cover a specific service or prescription, such as a GLP-1 medication.

PT-141 is the development code for bremelanotide, a melanocortin receptor agonist sold as the FDA-approved drug Vyleesi.

Rapamycin is the generic name for sirolimus, an mTOR-inhibitor drug FDA-approved in 1999 as Rapamune, for organ-rejection prevention after kidney transplant and for lymphangioleiomyomatosis.

Refill refers to dispensing a prescription drug again under a prescription that already authorizes it, rather than under a brand-new prescription.

Research use only is a label vendors put on peptides to claim they are not drugs for human use.

Retatrutide is an investigational triple hormone receptor agonist that activates the GIP, GLP-1 and glucagon receptors at once, tested for obesity and type 2 diabetes.

Rybelsus is an FDA-approved oral semaglutide tablet indicated for adults with type 2 diabetes, taken once daily on an empty stomach.

Sarcopenia is a muscle disease marked by a loss of muscle strength, quantity, and quality that builds up over a lifetime.

Satiety is the inhibition of eating that follows the end of a meal.

Saxenda is the brand name for liraglutide 3 mg, a once-daily GLP-1 injection approved for chronic weight management.

Selank is a synthetic peptide analog of tuftsin, studied in rats and in small Russian studies of anxiety patients, and sold online for anxiety.

Semaglutide is a GLP-1 receptor agonist sold under three FDA-approved brand names, each with its own indication: Wegovy, Ozempic, and Rybelsus.

Semaglutide vs tirzepatide is a comparison between semaglutide, a GLP-1 receptor agonist, and tirzepatide, a dual GIP and GLP-1 receptor agonist.

Semax is a synthetic heptapeptide analogue of ACTH 4-10, with the sequence Met-Glu-His-Phe-Pro-Gly-Pro, registered as a drug in Russia and sold there as nasal drops.

Senolytics are a class of drugs that selectively clear senescent, or aged and dysfunctional, cells from the body.

Sermorelin is a 29-amino-acid analog of growth hormone-releasing hormone (GHRH) that stimulates the pituitary to release growth hormone.

Sermorelin vs ipamorelin is a choice between two peptides that both raise growth hormone but act on different receptors and carry different FDA histories.

Set point theory is the idea that body weight is defended within a stable range by the body's own feedback systems.

SS-31 is the development code for elamipretide, an FDA-approved mitochondria-targeted peptide drug sold under the brand Forzinity.

Steady state is the point where the amount of a drug entering the body equals the amount being eliminated, so blood levels level off.

Step therapy is a type of prior authorization that requires trying a lower-cost drug proven effective for most people with your condition before the plan covers a costlier one.

Subcutaneous injection is an injection given into the fatty tissue just under the skin.

Sulfur burps is an informal name for belching that smells unpleasant.

Tapering refers to gradually reducing a medication's dose before stopping it altogether, rather than stopping all at once.

TB-500 is a synthetic seven-amino-acid fragment of the natural protein thymosin beta-4, covering amino acids 17 to 23 with an acetyl group at one end.

Telehealth is the use of communications technologies to provide health care from a distance, using tools such as computers, cameras, videoconferencing, and wireless communications.

Tesamorelin is a human growth hormone-releasing factor analog approved by FDA, as Egrifta WR, for reducing excess abdominal fat in HIV-infected adults with lipodystrophy.

Testosterone replacement therapy is prescription testosterone, a steroid hormone rather than a peptide, given to men whose bodies produce too little of it.

Thymosin alpha-1 is a 28-amino-acid peptide naturally occurring in the thymus that supports T-cell maturation.

Tirzepatide is a dual GIP and GLP-1 receptor agonist medication sold under two FDA-approved brand names, Zepbound and Mounjaro.

Titration is the label-directed schedule of starting at a low dose and stepping up over several weeks, used to reduce gastrointestinal side effects before reaching a maintenance dose.

TrumpRx is a federal website listing self-pay prices for certain brand-name medications, including Wegovy, Ozempic, and Zepbound, under agreements the White House announced with drugmakers.

Type 2 diabetes is a disease that occurs when blood glucose is too high because the body does not make enough insulin or does not use it well.

Types of peptides refers to the different classes of amino-acid chain compounds grouped by function, from FDA-approved GLP-1 drugs to GH secretagogues, copper peptides and antimicrobial peptides.

Vial and syringe refers to a GLP-1 dosage form supplied as a glass vial rather than a prefilled pen, drawn up and injected with a separate syringe.

VIP peptide refers to vasoactive intestinal peptide (VIP), a 28-amino-acid neuropeptide that acts as a neurotransmitter and helps regulate blood vessels, immune responses, and secretion of certain substances.

Visceral fat is fat stored deep inside the abdomen, around the internal organs, rather than just under the skin.

Wegovy is an FDA-approved semaglutide brand sold as both a weekly injection and a daily tablet under one label.

Wegovy at Costco / CVS refers to the retail pharmacy channels Novo Nordisk names as partners for its Wegovy self-pay pricing, not a separate discounted price at those stores.

Wegovy cost is the price a patient pays for Wegovy, which depends on insurance coverage and dosage form.

Wegovy coupon is Novo Nordisk's manufacturer savings offer that lowers the monthly cost of Wegovy for patients with commercial insurance or who pay without insurance.

Wegovy generic name is semaglutide, the nonproprietary name of the active ingredient in Wegovy, which is sold as an injection and as a tablet under one FDA label.

Wegovy pill is the oral tablet form of Wegovy, taken once daily and sharing one FDA label with the Wegovy injection.

Weight regain is the return of lost weight after a GLP-1 medication is stopped, a pattern seen across trials.

Weight-loss plateau is a stretch where weight loss stalls despite continued treatment or effort.

Wolverine stack is an informal, online-only name for combining the peptides BPC-157 and TB-500, sold for injury recovery.

Zepbound is a brand-name tirzepatide injection FDA-approved for chronic weight management and moderate to severe obstructive sleep apnea in adults with obesity.