Competing Interests: Conflict-of-Interest Disclosures: Abigail Ammerman is a full-time employee of H-E-B, LP and is president of the San Antonio Business Group on Health. Donna H. Ryan is a scientific advisor to Novo Nordisk, Wondr Health, Calibrate, Gila Therapeutics, Real Appeal, Epitomee, Xeno Bioscience, Roman, Lilly, Zealand, Amgen, Altimmune and Ysopia; receives honoraria for lectures from Novo Nordisk, and IFA Celtic. She serves on a Data Safety Monitoring Board for Rhythm and a study Steering Committee for Novo Nordisk and is a stock option holder in Epitomee, Calibrate, Roman, and Scientific Intake.