Who let you out of the “What are you listening to?” Thread?
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I’ll say more but I was in the lobby of my gym earlier and just finished working out. Metformin is one of the most prescribed drugs in the world–its cheap, minimal side effects (cept the occasional shits), and reasonably effective at reducing about 1% of A1C reading. The insurance doesn’t want to pay for GLP-1. Ask your doctor exactly what the conditions are for getting a script. I would assume A1C over 7 for three months while on metformin, but who knows.
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Metformin can help with weight loss
Downsides to glps that I’ve seen acutely is mostly nausea and vomiting
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This me. I keep telling myself that I’m significantly stronger and more fit, which I am, but haven’t lost much weight even on Ozempic and 4-5 days/wk fitness classes and reasonable eating. Feels like I need to eat unhealthy to lose weight, but I suspect I need to just keep gaining muscle (and people who see me think I lost weight because I’m stronger/fitter).
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Afaik, weight loss results with metformin are minor (few lbs) and not consistent across people.
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I read all you wisdom, sometimes
I Appeal to Gravity, or somthing
The way I’ve been eating on this weight loss kick is by no means reasonable and definitely not sustainable. Debatably healthy at best. I’m not keeping exact track, but I’m pretty sure I’m easily under 1500 calories a day, and I am exercising. Because I’m paying out of pocket (with the Lilly discount) I have been extra determined to get my money’s worth during the time I can take it.
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My personal view is.
What uses energy? brain
Heat
Consumption
Congestion
Movement
If you got muskels’ they use most of your intake of energy
I’VE USED MY BRAINS , on pizza?
im drunk bla bal bal
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The more muskkulx! the more combustion
ssupr ssmaretz
yuor velkom
no charge
So, this isn’t really a metformin issue, it’s a gatekeeping semaglutide issue. It’s true that metformin is the universal first prescription for diabetes and prediabetes, and it’s what all insurers would expect. If your A1C is over 7, you should probably take 500 mg. Some of the “longevity” fans also take metformin as a supplement, though the data is inconclusive.
In terms of metabolic effects, metformin isn’t entirely understood. It seems to be associated with more mitochondria in cells and/or foster the non-insulin mediated glucose uptake in cells. The latter effect is usually by an exercise induced “pathway”, where cells don’t need insulin to take up more glucose, but this seems to be a multimodal pathway, where studies that try to eliminate one component still don’t much blunt glucose uptake.
A current “controversy” around metformin is that 2-3 small studies have shown an interference effect with exercise induced mitochondria production, such that fewer mitochondria are produced with exercise + metformin than exercise alone, if the exercise is significant. I was on 2000 mg of metformin, the normal max dose, but now that I am exercising 4-5 days a week I have dropped to 1000 and now 500 mg. My A1C is now high normal, but it’s gone up a bit in the week since dropping to 500 mg. 500mg is 1000 mg less than in the studies, and the effects were minor, and metformin doesn’t hang around long, so I’m trying not to use within 8 hours of exercise.
Last week had a 6 month checkup, and my doctor (Kaiser) wasn’t, before appointment, big on prescribing the Ozempic (needed Dr to sign off on each monthly renewal), but I had dropped 10 lbs in 3 months, my A1C went from 9 to 6.9, my BP was down, and the Dr saw I was more fit, so she was generally quite happy and I told her I wanted to stay on Ozempic because lack of food noise makes a healthy diet easier to maintain. She was fine with that, even if she takes some shit from admin, because the patient now has fully managed diabetes with good labs.
So, it sounds like they want you to jump through some hoops for semaglutide, which is normal. It would normally be something for a Dr to prescribe after metformin alone “fails”. I suggest jumping through the hoops or finding a different provider or getting the script and using a compounding pharmacy. If needed, maybe cut out your Dr and get a script via an online consult.
A growing number of Drs are aware of the many benefits of semaglutide, but they are a minority and handling it out on demand could cause significant financial issues for many insurers.
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235 seems barely big for you.
Thanks for all the info. Very helpful. Im also on Kaiser, are you at liberty to say how much the Semaglutide is going to cost?
Also, I would very much not be an on demand customer. I have a BMI north of 40 and am over 3 bills, though tall. Im over 40, and its just starting to seem like I either lose weight or accept the fact that Im going to die in the next 20 years.
I’m paying $270/mo for Ozempic from Kaiser. It’s not exactly breaking their bank, given that I pay $600/mo for insurance and don’t have any other issues.
For big guys (and women) I don’t think there’s really any other option than purposeful exercise 3-4 days/wk, unless one works a physically demanding job. The general effects are significant enough that it more than makes up for the time spent just by having more focus and energy, even discounting the major health gains. I was going on 80 workout sessions at the time of covid lockdowns (after 10 years of sitting on my ass) and progressively got more sedentary during covid. I wish I would have hurried to get back into fitness classes 18 months ago instead of 3 months ago.
I don’t know the “magic button” with Kasier, it may be up to your individual Dr, but IMO a 40 BMI should automatically entail a script. As I told my Dr. (who I was planning to leave if she didn’t give me a script), “If I’m not a prime candidate for Ozempic, then who is.” However, I had been treated for controlled diabetes for 5 years, and most Drs see it as a diabetes drug, though it’s now been approved for weight loss (under the name Wegovy).
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I’ve still got a stomach bulge, which means visceral fat, which ain’t healthy. I think at maybe 215 that will go away completely.
Also I think my bones are finally going the other way and getting less dense every year. 235 felt a lot skinnier 15 years ago.
Went from 205 to 175 in 2 months on Zepbound. Only small issue is I have to actively remember to eat, especially sugar, or I get light headed.
Legit miracle drug.
I just played around with a BMI calculator and at 6’ I’d still be considered in the normal weight range at 137 pounds. I would look like I was on the verge of death at that weight.