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Consistently eating below roughly 600 to 800 net calories triggers metabolic adaptation mechanisms that reduce resting metabolic rate and accelerate lean mass breakdown

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Gonadal steroids can also influence GLP-1R expression in the brain and other tissuesin the whole hypothalamus, for example, the highest GLP-1R expression is found in the late proestrus stage (46), providing further mechanistic support for potentially higher sensitivity to GLP-1 effects during this phase of the cycle (33, 47)

Metformin is often considered for women with PCOS who have metabolic features or impaired glucose regulation, particularly as it has a well-established safety profile, oral administration, and cost-effectiveness

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