As if *this* wasn't predictable

Surely hope no one finds a new use for Repatha :thinking:


Using this drug well could be a huge mistake for most people. Casually using this drug to lose 20 pounds or less and ending up with a terrible side effect would be hell.

Well, it’s approved for use in obesity, so I doubt it’d be prescribed casually for someone with only 20 pounds to lose.

Having said that, I could imagine that a weight loss of just 20 lbs has the potential to make quite a difference to clinical outcomes in the right population.


Well, it’s approved for use in obesity, so I doubt it’d be prescribed casually for someone with only 20 pounds to lose.

They’ll just lower the limits of “obesity” like they did about 20-25 years ago. Poof! Now you’re obese. Here’s a pill

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I think you’ll find that any change to the arbitrary definitions of overweight or obese didn’t create a problem that didn’t already exist Poof! like magic out of thin air. That excess adiposity was there all along regardless of the terminology …and well before the cutoff point. “They” aren’t quite that powerful.

It is approved. That does not mean it wont be pulled from the market in less than five years because the chemical causes major problems to the patients. Most drugs are pulled from the market within five years because of the safety issues involved.

You nor I know who will use this. There are plenty of cosmetic drugs on the market that are used routinely. Just because the word obese is used does not mean it is restricted to OUR knowledge to the obese.

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Just because the word obese is used does not mean it is restricted to OUR knowledge to the obese.

Well, I’m pretty sure the drug had widespread use after its introduction for T2D specifically…and, as I’m reasonably confident some readers on this forum would attest, that’s not something that’s exclusive to obesity. Heck, I’ll bet a good few folk who get a new diagnosis would try to argue that they’re not even overweight (it’s just the sleight of hand with the BMI cut-off that’s given them that label )

There are more than a few adverse consequences besides metabolic dysfunction that’re associated with obesity other than vanity.

I think you’ll find that any change to the arbitrary definitions of overweight or obese didn’t create a problem that didn’t already exist Poof! like magic out of thin air. That excess adiposity was there all along regardless of the terminology …and well before the cutoff point. “They” aren’t quite that powerful.

I wasn’t addressing that. Of course some / lots o’ people eat too much. Did they autonomously make un-obese people suddenly clinically obese? Yes. of course. Ya can’t blow that off just because there are always people with weight problems.“They” do in fact have that kind of power. Just not all the time. They keep trying. Don’t confuse the two issues.


When I needed metformin in 2012 I asked my BIL an endocrinologist about the drug options. Metformin was the only good option. The rest were doing terrible things. Just because diabetes II is bad does not mean I need side effects from the med as well. Especially if the side effects are possibly worse than the disease.

Yep. Metformin is a great drug for those who need it. It’s been around a long time (was a standard for what has become known as T2D back when I was doing pharmacology in the early 1970s), relatively side effect free and its mode of action has a double whammy in that it reduces glucose production by the liver AND improves insulin sensitivity (almost as much as exercise). It works well…except when it doesn’t. And therein lies the rub. Whether it’s that unique combo of Nature and Nuture that makes us all different or simply individuals’ craptaculous lifestyle choices having too much of an impact, the simple fact is that some people need more and any potential side effects need to be weighed against the known consequences of leaving all the consequences of T2D unmanaged on a clinical needs basis.

Metformin is apparently considered something of a wonder drug in biohacking and longevity circles…with some folk taking when they have no obvious need. Beats me why anyone would do that, mind.


Just a flung theory to see if it sticks :stuck_out_tongue_winking_eye:

We know in animals the less they eat to a good degree the longer they live.

Metformin can stop the metabolism of food in the liver by up to 30%. That possibly could be said better. You can spell these things out better than I can. But I get that is probably the plot.

The other reason, I am taking metformin now even though my sugar is well under 99. The main bigger reason, while I do not have plaque I have calcium in the arteries. It is smart at age 59 to treat for T2D to keep things clean. I also do not need a statin any longer but take one. The doses are minimal for each.

Metformin was found in 1937 and rejected by the US for decades. Then it was a generic and continued to be rejected until what? 1997? Now it is considered the best line of defense having possibly fewer side effects than any other drug on the market.

That is interesting as well. Other than Metformin my BIL (Boston endocrinologist) is very wary on the rest of the T2D drugs. He rattled off the problems to me in 2012. They are a nightmare to take for many people.

Well, thinking about these things actually is interesting…I do it a lot. Primarily at the level of basic biomedical sciences…physiology, exercise science etc…which doesn’t translate to offering worthwhile opinions (but, at least, I know enough to know that😉)

I get a lot of my science info from podcasts with occasionally picking husband’s brain and textbooks and whatnot. Useful having a cardiologist daughter for new editions of the old staples we have on the shelves. Anyhoo, I started subscribing to Peter Attia’s podcasts about 18 months ago. He will generously inundate your email inbox with free stuff if you sign up (purely out of the goodness of his heart, I’m sure) and I found that the information in his free giveaways on topics I was interested in to be so useful as free standing stuff, so to speak, I ponied up the $$$bucks for the Full Monty.

Editing because I pressed a button inadvertently…I’m on my phone

I use his podcasts for my treadmill based Zone 2 training sessions (research on this on his podcasts is the teaser that got me hooked) and today was a Z2 training day so, knowing he’d had a couple of researchers on the subject of metformin use as guests, I listened to this one this morning. Turned out it wasn’t the one I wanted but I’ll put it here anyways because it’s a rabbit hole to dive down if, like me, you’re nerdy enough

About that CAC score…I bet mine’s bigger than yours! Decided on one earlier this year…99.999% confident that it’d reassure me that, like all my primary care physicians had said over the past couple of decades, my slightly elevated LDL-C was more than compensated for by my high HDL, exemplary lifestyle choices etc and that my risk status…per ASCVD risk predictor algorithm…was low. Well, they/I were mistaken. It’s aggressive lipid lowering therapy for me. My mistake was to discount family history…familial hypercholesterolemia. At least, I’m doing better than Jim Fixx.

Probably not as off topic as it would appear as the nuts and bolts of ASCVD are of more relevance (if not interest) to a good many folk here than Liz Truss’s resignation and whether BoJo is on his way back. Yep…I’m listening to a Radio 4 analysis right now

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P.S…my insulin sensitivity is quite high. Along with discussing the CAC scan, I asked my PCP to add an insulin test to the Usual Suspects with my blood work at the start of the year. Using the rationale that, if a rise in fasting blood glucose and A1c are late stage events in the departure from healthy homeostasis (which they are) I wanted to know if my “good” numbers are being achieved by my pancreas pumping out excess insulin before any damage was done. It were not. My husband did a quick calculation of my HOMA-IR and it was under 2 (1.35 off the top of my head…which is a good level of insulin sensitivity, apparently)


I am going to ask about testing my insulin sensitivity. But I will eventually towards the end of this year ask my BIL around Christmas time.

My mother’s mother lived to 98. She smoked till age 44, drank till age 97, was overweight and had bp problems. Her cholesterol later on would have been so so. She had a blockage at age 82, and angioplasty. No stent back then. Her siblings lived to between 88 and 94. My grandfather mother’s side also well up into their late 80s and 90s. Same conditions on each side of the family. Very little cancer. Strokes at advanced ages, 88 and up.

I just need to take care of myself. If I make it past 85 I consider it all gravy.

PS meant to say, using Metformin for longevity no matter what the logic is for a non diabetic makes zero sense. Metformin does nothing at all if there is nothing to do. Meaning it wont cut your calorie intake if you do not have a sugar problem.

@Leap1 @VeeEnn. Berberine is supposedly the less known cousin to metformin, supposedly offering similar benefits, with supposedly lesser side effects.

What are yalls’ thoughts?
Leap - does BL have any thoughts on Berberine?

Berberine is widely available OTC in the “supplement” aisles.

Some information links:

People most commonly use berberine for diabetes, high levels of cholesterol or other fats in the blood, and high blood pressure.

Berberine vs Metformin for Prediabetes and Mild Diabetes | Good Hormone Health.

Dr. Friedman is an MD PhD. According to the header on that page.
The goodhormone Dr provides a very brief comparison of Metformin vs Berberine.

Disclaimer: I’m NOT recommending Berberine or Metformin. If anyone asks I recommend “Diabetes for DIYers - The Weekend Project that can Become a Lifestyle”.



I have never heard of it before.

Be aware the supplements marketers are very dishonest people.

I was having trouble with stomach upset from metformin. Dr switched me to Jardiance. Much higher copays but problem solved.


Well you won’t be surprised by my comment, Ralph…which will be the same as those you read over the past decade or so on the H&N board…show me the evidence. It’s been touted heavily enough and for long enough that someone would’ve noticed it worked, if it worked.

Seems to me that folk are incredibly willing to dose up on any/everything they see recommended on an internet site…the less supportive evidence and plausible mode of action the better…just so they can avoid their chosen physician’s recommendations.

I’ve started on an old lipidology series on Attia’s podcast for my Z2/insulin sensitivity/diabetes avoidance training, the better to understand these GLP-1 inhibitors that’re the subject of this thread (didn’t take it in first time of listening when I didn’t realise the relevance to me) …wasn’t berberine enthusiastically recommended as an alternative to statins too?? That was a joke.

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I am glad that is working for you. The problem is the greater number of more serious side effects for a lot of people. Also there are differences in how the sugar and A1C are lowered. Metformin is far and away the better method. The other pills have methods that might not even count, but I can not do justice to that statement.

Metformin has one major side effect that can cause death in 1/30,000 people. That is why the doctors monitor Metformin carefully for two weeks. The smaller side effects are troublesome for some folks. But keep in mind that does not change just how safe Metformin really is.