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JSTOR 1564290

Starting low and titrating slowly gives your body time to adjust

Our study was not designed to address this question directly, and we therefore did not include such analyses

It also explains why simply lowering insulin resistance whether through weight loss, metformin, or, hypothetically, an incretin-based agent can improve both the metabolic and the reproductive dimensions of the syndrome: reducing hyperinsulinemia lowers the drive to ovarian androgen production and restores some SHBG, which is the biological basis for the interest in any potent insulin-sensitizing intervention

Visceral fat responds earliest and most dramatically to both therapies