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

@chippydoo This has zero to do with bad habits or sugar addiction. I have diabetes on both sides of the family, and I've been able to keep my A1C down to 5.8 and 5.9 over the last few years. Prostate cancer introduced a new factor into my equation - ADT. The driving factor of my most recent A1C increase is 100% ADT related.

ADT raises A1C by driving insulin resistance, increasing fasting glucose, and worsening overall glucose variability. The effect begins within the first 3 months, continues to rise at 6–12 months, and is strongest with long‑duration ADT (>6 months). I'm 9 months into an 18 month regiment.

I'm active, playing softball 2-3 times weekly for 2-3 hours at a time. I lift weights and do resistance band training. I have no sugar addiction; don't drink or do drugs. Diet? Yes, it could be better, but this increase is a direct result of ADT and why I was curious if others have used GLP-1s while going through ADT. It appears many have and with good results.

GLP-1 isn't a long-term solution - but may be a short-term tool to combat the impacts of ADT on the body.

I covered hereditary in my post.

@chippydoo Sugar is not the problem. It is the reduced ability of muscle tissue to take up glucose. With normal digestive function 75g of glucose can easily be processed (glucose tolerance test). Most sugar is stored in muscles or the liver as glycogen. If the muscles do not take up the sugar the body converts it to fat. That futher reduces the ability to process sugar. Reducing sugar intake is a way to manage spikes in an impaired digestive system. Of the many T2 diabetes drugs only GLP-1s and Pioglitazone directly increase the ability to move glucose out of the blood and into muscle cells. It is easier to take a pill, but also more effective if they are the right ones.

Yes, glucose resistance happens for many reasons and hormonal changes have a direct effect on that , both in women and men.

I do not see anything wrong with helping body to endure ADT onslaught during long-term ADT therapy 🤷‍♀️.

Some studies even show that GLPs can enhance cancer therapy results, so one can possibly have multiple benefits. Just my opinion ...

@chippydoo This is a huge battle between the ears. I’ve been obese most of my life from childhood. In 2020 I was getting within sight of diabetes. My doctor told me that losing 20 lbs. would correct it, and with my wife’s help and an old Weight Watchers menu I instead lost 40. In a couple of years I had gained back 10 and was holding on until diagnosis, and I’ve gained 25 since, mostly around the belly. So I’m basically back where I started. I’m exercising vigorously regularly but my fork is betraying me. My wife doesn’t want me to start GLP-1, because it seems only temporary, but I have to take action somehow.

I battle being on and off the type 2 spectrum myself. In my case it is clearly my diet. I consider how I eat a symptom of underlying emotional issues and use food to medicate. One might think being predisposed should be enough, it isn't in many cases. We all have to figure out what works best for us.

@jime51 Losing fat takes stress off of the capacity constraints that keep pre& diabetics from clearing glucose from the bloodstream in a rapid fashion. However, it does not increase the capacity. Losing 40 pounds should have lowered your A1c to normal levels. With regained weight that stress has returned and the capacity is probably lower than it was 5 years ago so you should do something.

On any diet it is use it or lose it. Resistance exercise is required to maintain muscle and increase the percentage of fat lost. There is nothing different when you end a diet either from Weight Watchers or using GLP-1s. If you go back to your pre-diet norms you will regain the weight. The problem is that to lose the weight on a normal diet probably took some changes in habits that will continue after the diet ends. GLP-1s suppress hunger signals that will return when they are discontinued. On a normal diet you probably gain some resistance to those signals. When I lost 40 pounds on a classic diet, I was hungry all of the time. That is the big difference with GLP-1s. You lose the weight but are not hungry. If you quit GLP-1s you have to have a lot of discipline to resist hunger signals and not go back to the habits that caused the weight gain. There is nothing magical that makes people regain weight lost on GLP-1 drugs. It is more that it was so easy losing the weight they do not realize the hard part in any diet is going to be keeping it off long term.

GLP-1s are natural hormones that your body produces. The drug versions are resistant to the DPP4 enzyme so are long acting. DPP4 destroys natural GLP-1 in 1-2 minutes so not the same hunger suppression. Before GLP-1s, the ...gliptins were developed to suppress DPP4, extending natural GLP-1 life and lowering blood glucose.

I got good results from Intermittent Fasting in the past. I followed 16:8 protocol Fasting 16 hours eating in 8 hour window. My eating window was &AM to 3PM. That was in 2020 before I was diagnosed with PCa in 2024. I practiced IF for one year strictly. Now I follow 12:12!

@jime51
Unfortunately, if you are on ADT and have low testosterone, the problem is much bigger than you expected.

Low T causes a sluggish metabolism, reduced muscle mass, increased abdominal fat storage, and low energy for exercise. Low-T creates a cycle where weight gain further lowers testosterone, requiring lifestyle changes or medical intervention to break.

Cutting out meals for weight loss often backfires by causing your metabolism to slow down and promoting fat storage as the body enters a survival-oriented "conservation mode". It leads to nutrient deficiencies, intense hunger causing overeating later, energy crashes, mental fatigue, and potential muscle loss.

Between low T and the inability to cut out meals. It’s really annoying how hard it is for prostate cancer patientsto lose weight. When it comes down to is we really need to change our diets.

@jim18 Thanks. When I lost weight, glucose was 98 and A1C 5.4. In April, those were 113 and 5.8. My wife has gained, too, perhaps a bit like “sympathy” weight gain among men during their wives’ pregnancies. I tried vegan for a while during treatment, but my wife wasn’t willing to join me. Weight Watchers’ Simple Start low-carb, low-fat program has worked because quantity isn’t limited, just selection. Now to do it.