Endocrinology-Diabetes Questions Polycystic Ovary Syndrome

In spite of Glycomet medication, my weight is constantly increasing. What should I do?

I am suffering from PCOD and my insulin levels are constantly increasing. My doctor has put me on Glycomet SR to lose weight and hence improve my PCOD. However, my weight has still been increasing. What should I do?

11 Answers

Glycomet is given to improve your body's insulin response , which as a secondary benefit may lead to weight loss; however it not a weight loss remedy per se. Diet selection and exercise must go together with the medication prescribed. Confer with your Physician in this regard.
Make an appointment with a dietician and continue your medication as it is prescribed.
I would get checked to make sure you are not developing type 2 diabetes mellitus.
Watch diet and exercise regularly
The American Association of Clinical Endocrinology guidelines include the use of GLP-1 angonists in pre diabetes. PCOD is a form of pre diabetes and you should discuss this with an endocrinologist.
I would consult an endocrinologist for a full evaluation and discuss with them after the workup completion as what the source and problems maybe for you in your attempt to lose the weight.
There are many reasons this can happen and I advise you sit with your physician regarding your concerns.
You need to cut calories intake to 1500 and do regular exercise and check fasting by sugar and insulin at the same time see what your doctor says
There could be other issues going on with your body - please have the doctor check your adrenal, consult a nutrition specialist, and ask to have an imaging test of your pancreas to start.
I am sorry you have to deal with PCOD (aka PCOS). This is short of polycystic ovarian disease (or syndrome).

Glycomet, known traditionally by its generic name metformin, is a medication frequently used in PCOS. This is a medication that is also used as first-line therapy for type 2 diabetes. It is NOT a weight loss medication and will not decrease your insulin levels. It is considered by me (and nearly all Endocrinology Specialists) as a "weight neutral medication". In this, it causes neither weight gain nor significant weight loss.

The main mechanism by which this medication works is to reduce to amount of glucose (sugar) storage in the liver and to reduce the release of glucose. It reduces a process called gluconeogenesis, which is "new" "glucose" "making".

Our bodies are designed to store energy / glucose in the liver. This is stored as something called glycogen. When we are fasting (often while sleeping overnight) we release / make glucose to give us energy. We need this energy to maintain our breathing, temperature, dreaming / brain function.

Metformin, in a sense, dials this down.

For those with PCOS, the mainstay is to focus treatment at symptoms. Some people suffer from excess androgen (male hormone testosterone or its derivatives). Some people suffer from abnormal menstrual cycle.

The goal for a medical doctor like me is alleviate those symptoms. For abnormal menstrual cycle we use oral contraceptives (or IUD). For excess male hormone we can use an androgen blocker like spironolactone.

PCOS does not CAUSE weight gain but is made worse by excess adipse (fat) tissue. Hence, we should direct treatment to weight loss. This often can normalize periods and alleviate the insulin resistance and excess male hormone. This may mean meeting with a Registered Dietitian (RD). This may mean doing a Food Journal and documenting calories. Or, this may mean all of the above with medications directed at weight loss.

Hope this helps provide some insight. We doctors are not always good about giving realistic expectations.

Best of luck to you!
What should you do to lose wt.? Simple decrease your food intake & increase your calorie burning (exercise). Never depend on medications to lose wt. They are a help but life style change is more effective. Remember Newton's law of thermodynamics: Energy is neither increased or decreased in the universe, it is only changed from one form into another. So if you consume more energy (food) than you expend for energy (activity & exercise) the excess energy consumed is converted to another for (fat). To get rid of the fat you must burn more energy (exercise) than you consume (food). Medications are a help but cannot do the job without your help. The medications just help you not want as many calories, they do not help you burn calories. Consult a dietician & an exercise specialist to help you outline a good program that fits your capabilities.