I'm a college student in Rome who had a Permit to Stay that expired in January of this year. I have not been able to apply for a renewal yet, and have plans to return to the USA for the summer before returning to school in Italy in the Fall.
Can I file the request for a new Permit to Stay while in the USA, or does it have to be done from Italy?
Back in Dec 2024, I went for my annual checkup and asked my new doc for help in getting my weight under control. I've always been a bit husky since I was young, and had gotten up to 230 lbs (5'10" M) at this time. He suggested giving a GLP a try, and to be quite frank I hadn't really thought about it, or knew anything about it at that time. So I started taking Zepbound under his direction, when a week later, he calls me back with my lab results and says my A1C is 6.6.
Of course, I've gone through this world a bit oblivious to what an A1C is, though upon looking back at previous labwork it looks like I had been testing in the 5.7 range for about 10 years up until this time. I had a blood clot 15 years ago, and the doctors at that time could not come up with a reason why, but now I'm of the belief that this may have been an early warning shot of metabolic issues ahead.
Anyway, so I continued along with the Zepbound, and ended up losing about 45 lbs, in a very steady, pretty much (for the most part free of side effects) for about 9 months.
We took a relatively straight route to 15.0 mg, as I think that was the trend amongst many prescribing GP's back then given the Lilly directives at that time. Never really lost any weight on 15.0, as most of it came off at the 7.5 and 10.0 levels over those first 9 months.
I'm now on Mounjaro (given my 6.6 score back then, and the fact that my insurance ended my Zepbound coverage in July 2025), and over the last almost 9 months I really haven't lost any additional weight, and it feels like the weight loss benefits of the GLP are likely no longer applicable for me.
At 180 lbs, and with pretty good labwork (A1C is currently holding steady at 5.4) across the board except for a higher than ideal LDL, which I think is in part because I've been focused a bit on eating less carbs and more fat than in the past. A year and a half after starting the GLP, I'm left pondering next steps, if any. I have no issues with continuing on with the drug, as I'm sure it's likely providing benefits in terms of glucose control, inflammation, etc. But do I need to be on 15mg, or should it be a smaller dose, and does it matter? And how would I tell?
Again, no real negative effects to the drug at this point on my end, but just trying to figure out future plans, recognizing that as time goes on circumstances could always change.
I've never seen an endocrinologist, but my understanding is that as long as I'm taking Mounjaro that there is little testing they could do to give me any sense as to insulin resistance levels or other notable diabetic markers, which given my current situation, may not be all that important to know anyway. Any thoughts on the value of seeing one at this time?
Appreciate any and all thoughts, thanks!