A side effect of healthcare being a for-profit system in the US means it runs the gamut, from a doctor you meet with in a clinic irl, to a doctor you never actually meet online, you just fill out some digital paperwork for, to the exteme where users get chemicals from sketchy websites and do chemical prep at home. The middle ground is to use an online "pill mill" that ships out from a compounding pharmacy, often not covered by insurance so paid out of pocket. Maybe $300/month? According to online sources aka reddit it's fairly accessible, just fill out an online questionaire and get a prescription from a doctor, followed by getting the medication shipped to you. It was a bit more open during Covid, but it's still relatively accessible. If you do have a high BMI then more mainstream sources are available to you though.