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The two reasons are that CBS is activated by estradiol and betaine (Bet), which is twice as high in females compared to males because the enzyme PEMT [Figure 1] is activated by a factor of 2.3 in menstruating females

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Evidence-based levers that reliably move the needle: A sustainable calorie deficit with adequate protein Resistance training plus daily movement Sleep and stress management (often underestimated) Clinician-guided options when appropriate, including FDA-approved obesity medications (e.g., Wegovy and Zepbound ) and weight loss injections A good rule of thumb: don't outsource a fundamentals problem to an unproven tool