GLP1 to combat weight gain and A1C increase while on ADT?

Yes, I was on Mounjaro 5mg & 7.5mg while on ADT (Orgovyx). Stayed on the lower doses since I did not want to lose too much too fast. A1C went from 8.0 to 4.9 in 18 months. My muscle percentage actually increased with resistance training. Lost 25 pounds while on ADT, 40 pounds overall. Typically, will lose at a higher rate for the first 6 months on a GLP-1.

If you are in USA on Medicare and your BMI is 27.1 or higher than you will qualify for the CMS demonstration program that provides Zepbound KwikPen or Wegovy at $50 per month as pre-diabetic (A1c from 5.7 to 6.4). Zepbound does the best at weight loss and suppression of hunger. Need a prescription and to be turned down by your plan D (or Advantage). Subsidy is covered by CMS so this will get approved if you meet the BMI. Since it is not part of normal drug coverage the $50 is not applied to the drug deductible or maximums. This is additional out of pocket.
If you were not prediabetic the BMI requirement is 35.0 or higher. This program started in July 2026 and ends in December 2027 but that will cover your ADT with a few extra months.

A recent study showed that if people get on the scale every day and eat based on what they weigh, they don’t gain weight, Or gain very little. I followed this practice for many years, and I’ve been on ADT for eight years. I’ve never gained more than a couple of pounds from ADT and my A1c was 5.4 the last Couple of times I had it done two months ago.. They found that people that don’t get on the scale more than once a week tend to gain weight.

Yes, ADT can cause you to gain weight and as a result raise your A1c, but eating carefully and watching how much you eat can make a major difference. I’ve been keeping track of the Carbohydrate ratings on foods And eating a big salad every other day for lunch, That helped enable me to keep my A1c down. Of course, I watch out what I eat it breakfast and dinner as well. I had brown rice instead of white rice. I eat whole wheat pasta instead of white pasta.. There are many things you could do besides GLP-1.

I’m 6’ 4” and weigh 190. The most I’ve ever weighed is 196. That was due to eating too much during the holidays. I cut back a little for four months and lost that.

So starting out on ADT, watch your weight every day. Base what you eat and what you weigh.

@jeffmarc I agree 100% - but the old saying applied here - for me at least - "easier said than done."

I'm 5' 7" and have gone from 180 to 193 lbs in 9 months. Can I eat better - absolutely. Does ADT make that even more difficult for me because of how my body is responding? Yes.

My A1C was near 6.2 a few years back and I adjusted my diet and got it down to 5.9 on my own. Then it slowly crept up and I went on Metformin. Back down to 5.9 consistently the last few years until ADT kicked in and it jumped to 6.3.

I'm hoping the GLP1 would be a quick way to get everything under control - BUT - it's not the ultimate answer. I need to control my diet better - I know that.

Thanks for the feedback!

If you need GLP1 get it . You will not loose muscle if you exercise them with weight training and resistance training which you should do anyways if you are on ADT . According to new guidelines one can get Wegovy if one has any cardiovascular risk regardless of BMI. Since you have diabetes and diabetes increases cardiovascular risk you should be able to get Wegovy completely covered by Medicare. As far as I know, there is Wegovy in a pill form now and it should be much more fordable.

Of course as @jeffmarc wrote - correct nutrition and exercise are the most important parts for any A1C or weight gain problem and should always complement any medical treatment to make it doubly successful. For many it can provide complete solution and for others that need some extra help taking GLP1 meds is OK too. There are some studies that actually show that GLPs help with cancer control and make treatments more effective but much more time is needed to see if those finding truly hold up.

@surftohealth88
One of the biggest problems in getting GLP1 is paying for it. My daughter tried to get it through her insurance, but they told her unless her BMI was 30 or higher It would not be covered. She is not that overweight. We are helping her pay for it.

I wonder how many other insurance companies have high limits.

Similar story as yours. I completed five sessions of high dose proton radiation therapy and was placed on Lupron ADT for 12 months. I became extremely lethargic, had difficulty exercising and pretty much felt like a slug during that time. By the end of the 12 months of ADT treatment I had gained 60 pounds, lipid profile was significantly negative, and began to show signs of some fatty liver accumulation. Of note, I am not diabetic.
Candidly, I had difficulty exercising while on ADT, however, felt that I ate a fairly healthy diet. At the end of my treatment, I started on tirzepatide (Zepbound) and over a period of eight months lost all of the weight that I had gained. I also began a strenuous exercise program, including daily aerobic exercise and weightlifting 3 to 4 times weekly. additionally, I initiated a diet that was high in protein supplementation. Lipid profile improved to normal, fatty liver issues resolved, and I remain on a maintenance dose of tirzepatide (2 years later). Bottom line, GLP – 1 drugs worked extremely well for me. Good luck.

@jeffmarc
Is she just trying to loose weight and otherwise has no health issues ? If that is the case, now that Wegowy comes in pill form it should be much more affordable. Also, she might look into weight loss programs that now include providing GLP meds supposedly at much lower cost since they buy in bulk like

https: //ro.co/lp/weight-loss/quiz/?utm_campaign=23737003642&utm_term=&utm_content=&utm_source=google&utm_medium=cpc&gad_source=1&gad_campaignid=23727162714&gclid=CjwKCAjwsfzSBhB5EiwAOGyqSYdrJbGXy_2QbyD5k-ZRlRUEizOi-BEv937tUovyFF9XxoFKoKki6hoCWUgQAvD_BwE

or
https://bestweightloss.io/weight_loss_USA_D_ENG_comp_noom.html
I never looked closely into those programs but there are a lot of commercials promising better pricing and easier access. I hope this was of any help. My older daughter might benefit from GLP but she is afraid of trying it, she is "scaredy cat" in general . I love her to death but she often complicates her life for no reason. : (((

@jbristow3682 At 5'7" as long as you weigh 173+ pounds you have a BMI of 27.1 and qualify for the prediabetic program if on Medicare.

The Wegovy pill is not easy to take. Need to take the pill on an empty stomach (at least 4 hours since last eat/drink) with no more than 7 oz. of plain water and not eating or drinking anything for another 30 minutes. At maximum dose you get 175mg of semaglutide per week from the pill and 2.4mg from the injection. The Wegovy injection is more effective. The Zepbound injection is more effective than either form of Wegovy. Both injections use very small needles (32 gage 4mm) designed to inject into fat tissue. Either can be done at anytime without regard to eating/drinking, etc.

The Lilly pill (Foundayo) is not as effective as the Wegovy pill at maximum doses. However, it can be taken at any time of day with or without food or drink so is much more flexible. You can get this pill as effective or more effective than Wegovy pill at all doses except 25mg.

Both pills still require titration (like shots). Starter doses are $149, then $199. The effective doses are both priced at $299 for a 30-day supply. The Wegovy shot and Zepbound also have lower cost for the starter doses. At effective doses the cash Zepbound price is $449 for 4 injections while Wegovy is $349 for 4 injections. Since there is competition in the cash business both are cheaper than Ozempic or Mounjaro which are the same injections marketed for diabetes.

I would stay away from the compounders. Semaglutide went generic in India in March and there are now 6 India pharmas selling the injections. Since these must be kept refrigerated, there is an issue with getting it from overseas.

@jeffmarc I do not know any insurance that has a low BMI for weight loss. Need another condition such as prediabetes, fatty liver, certain heart issues, etc. to get it under 30 BMI. The Medicare demo program requires 35+ BMI at the start of GLP-1 treatment for obesity. Without going through compounders the direct sales outlets from either Lilly or Novo provides the lowest cost. Then there is off label dosing to cut cost. Easy with Lilly vials or Novo pen.

@jim18
Here’s one site I heard about that supplies Many different drugs,at lower prices. They’ve actually gotten many pharmaceutical companies to reduce their price because they couldn’t handle the competition at the lower prices.

Some of their drugs are produced by compounding. They also won’s just take a prescription. My daughter couldn’t get a GLP1 Drugged from them because she has a heart issue. She can get it through her medical Provider but has to pay for it.

They started out as hims and are now hims and hers.
https://www.hims.com/