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Four specific conditions qualify for Tier 3 (BMI 27 or higher): (1) prediabetes per American Diabetes Association criteria (typically A1c 5.7 to 6.4 percent, fasting glucose 100 to 125, or 2-hour oral glucose tolerance test 140 to 199), (2) previous heart attack (myocardial infarction), (3) previous stroke, and (4) symptomatic peripheral artery disease

When combined with a balanced diet and regular exercise, noticeable changes in body composition and energy levels can typically be observed within a few weeks of consistent use