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There's a growing contingent choosing a third option - stacking multiple compounds designed not just to maintain what they had at 25, but to optimize for the decades ahead

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By the mid-2000s, the obesity pharmacotherapy field expected at least 5% placebo-subtracted weight loss for regulatory consideration, a threshold later codified in FDA's 2007 guidance for industry on developing obesity drugs

Adding an aromatase inhibitor, like anastrozole (sold under the brand name Arimidex) can help bring estrogen down, says Calvert

Results: Among the PCT drug samples, 33.3%, 25.4%, and 41.3% indicated the presence of SERMs (tamoxifen and clomiphene), AIs (anastrozole, letrozole, and exemestane), and other substances (hCG, cabergoline, and mesterolone), respectively according to the label