Lots of ways around jurisdictional regs. Consider how many people live near a national border, or have access to the postal service.

https://www.usnews.com/news/best-states/articles/2018-11-01/...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7523158/

https://www.cnn.com/2023/03/07/health/fda-drug-shipments-khn...

https://www.usatoday.com/story/news/health/2022/12/14/states...

Also, I expect CRISPR or gene therapy to be the long game wrt this and updating the body's GLP-1 regulation, versus maintenance doses of a pharma product. This is a shim.

https://benmay.uchicago.edu/crispr-gene-therapy

https://www.creative-biogene.com/crispr-cas9/solution/glp1r-...