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In clinical practice, weight losses of 5% and 10% are commonly used thresholds for clinical significance. PCOS guidelines state that a weight reduction of 5% can significantly improve insulin sensitivity and hyperandrogenic load, while 10% weight loss is strongly linked to restored ovulation and improved pregnancy rates (17)

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IF enhances metabolic flexibility and energy efficiency by promoting fatty acid oxidation and inhibiting its synthesis through the activation of AMPK and SIRT1 signaling pathways (913, 23, 24)

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