How can a 45-year-old manage weight and insulin resistance?

Question

Hello doctor,

Hi, I am 45 and have been struggling with being overweight for over 10 years. My doctor said my BMI is 38, and I recently found out I have insulin resistance. My HbA1c came back at 6.2 %, and my insulin level was high as well. I have been on Metformin for the past three months and have been trying to eat healthier and exercise, but I have not lost much weight. Are there any newer weight loss injections that might be more effective than Metformin? Should I get a scan to check how fat is distributed in my body? Additionally, how often should I undergo blood tests to monitor whether my condition is improving or not?

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I can tell you that with a body mass index of 38 and confirmed insulin resistance (glycated hemoglobin of 6.2 %), you are in the early prediabetic range, which means we have a real window of opportunity to reverse or delay progression. While Metformin is helpful, especially for insulin sensitivity, newer glucagon-like peptide-1 receptor agonists like Semaglutide or Tirzepatide have shown significantly better results for both weight loss and glucose control. They not only lower appetite but also improve insulin resistance. These are safe and effective when used appropriately and can often lead to 10 to 15 % or more body weight loss over time.

A dual-energy X-ray absorptiometry scan or abdominal ultrasound can be useful to evaluate fat distribution, especially visceral fat, which is more metabolically active and associated with a higher risk, but it is not mandatory unless there is concern about fatty liver or metabolic syndrome. As for monitoring, I recommend checking glycated hemoglobin, fasting insulin, and lipids every three to six months during active treatment, especially if you are on medications. Keep up the healthy habits; it takes time, but with the right medication support, progress becomes much more achievable and sustainable. Let us aim for gradual, steady improvement and not get discouraged by slow early results; what matters is long-term change.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.