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These include: Lifestyle interventions (dietary advice, physical activity programmes) Licensed pharmacotherapy such as orlistat, or GLP-1 receptor agonists including semaglutide 2.4 mg (Wegovy, NICE TA875) or tirzepatide (Zepbound) where clinically indicated and available Referral to tier 3 or tier 4 weight management services , including bariatric surgery assessment where appropriate Information on NHS weight management services and eligibility for licensed treatments is available via the NHS website and NICE guidance

Your doctor may order tests, including: Blood tests, including levels of IgG4 antibodies (though high levels alone arent enough) MRI or CT scans to look for swelling or inflammation in the brain, sinuses, or other tissues Doctors sometimes perform a biopsy (tissue sample) to confirm inflammation patterns typical of the disease

Important Notes Practical considerations for consistency and safety

doi: 10.3390/microorganisms9071449 13 JanowitzCNakamuraYKMeteaCGligorAYuWKarstensLet al