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Victoza isn't the first drug of choice if one merely wants to lower their A1C. Metformin will do the same thing and is much, much safer... and used daily by millions. Your endo will determine what is right for you. The most common dose is 500mg 1tab/twice daily.

My bariatric surgeon told me that after my surgery that I no longer need to take Metformin. (I am not diabetic, btw; and my A1C never rose above 5.8 ... thanks to the Metformin I took pre-surgery.)

Metformin also affects hunger. Many people lose weight from it as a bonus. It's not the reason why doctors prescribe it, though.

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The reason I mentioned A1-C is because it may indicate a co-morbidity that their insurance would cover treatment for.

GLP-1 agonists such as Saxenda and Victoza are approved for weight loss, in higher doses, with the side benefit of reducing A1-C levels.

Personally, if my BMI was in the low thirties, I would seriously consider medical weight loss alternatives vs. surgery.

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Hi, I'm in the UK so think the rules may be different here but my BMI is 32 and I've just had a band fitted. I wasnt able to get this on the NHS (our miracle healthcare system) because of my low BMI so I took out a bank loan to pay for the op myself. Here if your BMI is over 30 you are eligible but there has to be genuine reasons for you wanting to go down this route. For me, I was similar to yourself and have tried every diet in the book to no avail. My weight yo-yo'd for around 15 years and once I turned 30 I just got heavier and heavier despite my attempts to lose weight. I know my problem is my relationship with food so for me the band will eventually allow me to eat what I want but I will only be able to physically eat so much of it before I am sick. I need this kind of control. I had to sign a consent form as this wasn't a medical referral but a medical choice. I have recently been diagnosed with arthritis and believe if I don't take my weight under control that my condition will get worse. I'm also leaving myself open to diabetes and this is something I don't want in my future. My doctors accepted these as valid reasons and I was able to get the band. I'm sorry I really don't know too much about US healthcare so I'm unsure if any of this is helpful! Best of luck x

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Here is my perspective from a 42 year old that was diagnosed with PCOS at about 23 when the weight just started piling on at 21-22. PCOS is awful, I doctored with everyone I could, endo etc. My endo told me one time to consider not gaining a victory and that I would probably never have a healthy weight. My highest ever was 280, I lost to 198 on my own over several years using low carb diets. It was such a hard battle, but my body would not relent and for a good 15 years I gained and lost the same 30 lbs over and over again. PCOS is a precursor for lots of future issues with Diabetes, heart disease etc. I am an exercise guru, I love running, biking, I compete in triathlons. I would eat healthy, exercise and nothing would happen. I took metformin, I did Protein Shakes, med weight loss program with diet pills, weight watchers, topamax. No results. The year before my wedding, I worked with my primary dr to try to lose weight for my wedding. I did a shake diet that was about 1000 calories a day, high Protein, low carb - and also took Victoza off label for obesity so 3.0 ml which was 2 shots since the pen only went to 1.8 max dose. In 8 months, of this diet, meds, and exercise, I lost about 24 lbs. My dr and I had agreed that the victoza was a short term thing because of the side effects possible, so I quit taking it a few weeks before my wedding and immediately started gaining the weight back. I always knew, from the battle I had, that surgery was my only option. Unfortunately, prior to getting married, my insurance I had exempted it, but after I got married, I switched to my husbands insurance so I could start trying to get qualified. In the 6 months from the Victoza to my surgery on March 18th, I gained 46 lbs. I struggled with which surgery to have, scared of the bypass, but I knew in my heart, that just restricting my eating wasn’t the solution. I had done this for years and it didn’t work. I needed the malabsorption part as well so I did have the RNY.

I feel very strongly that PCOS should be a comorbidity for surgery. I didn’t have any comorbidity’s because I had such an active lifestyle, but I knew it was only a matter of time. I still have fears that this won’t work either, but I know deep down, I had to do it. I think you have to advocate for your own health and find a surgeon/program that believes in you. I surely hope that I can have success and get to a healthy weight. Do what you feel is right, but find a team that supports you. I have heard that some insurance does allow PCOS to be a comorbidity, so something to research and look into.

Good luck to you.

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