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Eligibility requires BMI of 35+, or BMI 30-35 with heart failure, uncontrolled hypertension, or CKD stage 3a+, or BMI 27-35 with prediabetes, prior MI/stroke, or symptomatic PAD

Factors that increase estrogen activity include: Low Sex Hormone Binding Globulin (SHBG), which can be caused by blood sugar dysregulation and higher insulin production, allowing higher free estrogen Xenoestrogen exposure (environmental endocrine disruptors like BPA from plastic) Excess adipose (fat) tissue (aromatase activity converts androgens to estrogen in fat cells) Impaired hepatic estrogen metabolism Chronic Inflammation Fibroid tissue has a distinct inflammatory microenvironment

HGF mimics also advantageously avoid the development of disorders of impulse control behaviors (such as medication overuse and craving, binge eating, hypersexuality, or pathological gambling) and varoius psychotic symptoms (e.g

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& DeBose-Boyd, R