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Regarding probiotics specifically , expert guidance suggests: No major medical organization currently recommends probiotics as a weight loss intervention Patients interested in gut health optimization should focus on dietary fiber (25g daily for women, 38g daily for men) and fermented foods rather than supplements [29] If patients choose to use probiotics, they should inform their healthcare provider and select products from reputable manufacturers with third-party testing (USP, NSF, ConsumerLab) Clinical referral triggers include patients seeking probiotics as alternatives to indicated medical therapy, those with unrealistic weight loss expectations, or individuals with eating disorders

Combination of PIO with SLGT2 inhibitors Preclinical evidence The possible activities of ipragliflozin (IPRA), PIO or their combination on a variety of diabetic features (IR, hyperinsulinemia, obesity, dyslipidemia) and the progression to NASH were explored after their administration to high-fat diet-fed KK/A y T2D mice [113]