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Notably, most clinical investigations studied women (1404 female versus 83 male participants), which is expected since estrogen declines after age 30 years, and further estrogen decline with aging represents health challenges, as well as a reduction in QOL [9, 10, 19,20,21,22] and a degradation in the most visible organ of the bodythe skin [9, 10]

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This mechanical effect contributes to prolonged satiety after meals and reduces the desire to eat

2004 Oct;8(5):363-71

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But the gastrointestinal effects are unpleasant enough that many people discontinue within the first few months