Even with optimal T, your GH levels are dropping 14% per decade, degrading sleep quality, recovery speed, fat metabolism, and tissue repair
Some people with endometriosis struggle with weight gain linked with inflammation, reduced mobility, or hormone-related changes, while others experience difficulty maintaining weight because of pain, nausea, or appetite disruption
Potential advantages Often a strong option for patients with significant reflux May be especially helpful for patients with type 2 diabetes or metabolic disease Can be used as a revision option after Lap-Band or sleeve in selected patients May provide more weight loss for some higher-risk or higher-BMI patients Long track record in bariatric and metabolic surgery Important considerations More complex anatomy than gastric sleeve Higher need for lifelong vitamin and mineral compliance Dumping syndrome can occur, especially with high-sugar foods NSAID and steroid use may be restricted because of ulcer risk Requires careful long-term follow-up Which Procedure Might Be the Best Fit

In October 2017, following a unanimous FDA Advisory Committee approval, the injectable version (Ozempic) was approved for diabetes treatment in the US and later in other countries, including: Canada European Union Japan Australia The oral version (Rybelsus) received US approval in September 2019, with EU approval in April 2020
Zonulin and its regulation of intestinal barrier function: the biological door to inflammation, autoimmunity, and cancer