HGH vs GLPs for Central Adidposity

[BimbapLover]

Since this is my first post on the forum, I will include my background:
Age: mid 20s male
Height: 5'7
Weight: 143 currently
Exercise: weights 3x a week (couple years), and walk a couple miles a day

Was 170 lbs 8/1/2025 and had bloodwork done.
Triglycerides: 116
Total Cholestrol: 220
HDL: 46
LDL: 151
HbA1c: 5.8
Fasting insulin: 15
IGF-1: 180
ALT: 98

Diagnosis: insulin resistant/prediabetic. I started retatrutide and dropped to 138 lbs by 11/3/2025. I got very lean everywhere except my abdominal area. I also lost a shit ton of strength, and probably muscle. I thought this was just glycogen depletion from being so low carb, but even a month after stopping reta and eating more carbs the strength loss is still there.

Question: Is it possible I still have a lot of abdominal fat because of low endogenous GH production? I don't really feel like it's healthy for me to lose any more bodyfat, but I also don't understand how I simultaneously have love handles while being lean everywhere else.

 

[Ghoul]

Your insulin resistance at 5.8 A1C promotes central adiposity.

But the demon here is that central adiposity creates an insulin resistance promoting environment. A viscous cycle nearly impossible to escape.

Visceral fat is a highly active metabolic organ. When it’s present in excess, it creates a high inflammation environment, especially in the liver, bringing your IGF-1 down into the bottom ~15th percentile you’re in now. This near GH deficiency also promotes central adiposity.


You’re in the ideal window of time to reverse pre-diabetes, But it’ll require busting that central adiposity, and dedicating yourself to at least 150 mins a week of level 2 cardio.

All we can do with the magic chemicals is release the free fatty acids from their locked down state within visceral fat, but if you’re not burning them off with cardio. They’re going right back where they came from, because of your high A1C.

You have the right idea with rHGH but wrong compound for this job.

The problem is rHGH will worsen your A1C while it sends the signal to release visceral fatty acids locked down by your high insulin. You’re trying to get visceral fat to release them, while insulin goes up even higher locking them down tighter.

You need Tesamorelin. For 6 months or more, combined with cardio. It has a far more targeted effect on visceral fat than rHGH. So even though it will also raise A1C, it won’t do so nearly as much in proportion to visceral fat reduction.

What should start to happen, noticeably around the 3rd or 4th month, is A1C begins to drift down, as visceral fat loss begins to result in metabolic improvement. This will accelerate, by 5th or 6th month your abdomen should be visibly smaller, A1C normalizes, and you approach reversal of your prediabetes.

How long you remain on, or switch to more potent rHGH at that point to try and reduce visceral fat more will depend on what a dexa scan shows, but at some point, hopefully, with lowered A1C you’re no longer promoting visceral fat storage, you can come off and maintain your non-pre diabetes status. Then when your natty IGF-1 recovers it should be much higher (no more visceral inflammation suppressing it) also no longer promoting excess visceral storage,

In other words, if successful, you’ll have broken the cycle of visceral fat causing high A1C and low IGF, which in turn promote visceral fat, and no longer be pre diabetic.

The GLP will compliment this process and you should of course stay on.

 

[BimbapLover]

Thank you for that detailed response.

You need Tesamorelin. For 6 months or more, combined with cardio. It has a far more targeted effect on visceral fat than rHGH.

I researched this initially and also considered the GH secretagogues. One thing I forgot to include in my original post is that I took ipamorelin for about a month during my reta cycle. I felt nothing from it, and I noticed no changes in body composition, so I discontinued it. My understanding is that the GH secretagogues rely on proper pituitary function; but exogenous GH can bypass this entirely. Do you think I should still try Tesamorelin even though Ipamorelin did nothing for me?

and dedicating yourself to at least 150 mins a week of level 2 cardio.

Is cardio inherently important here to getting rid of visceral fat, or can I accomplish the same goal by just being in a deficit?

 

[RockyP]

Thank you for that detailed response.

I researched this initially and also considered the GH secretagogues. One thing I forgot to include in my original post is that I took ipamorelin for about a month during my reta cycle. I felt nothing from it, and I noticed no changes in body composition, so I discontinued it. My understanding is that the GH secretagogues rely on proper pituitary function; but exogenous GH can bypass this entirely. Do you think I should still try Tesamorelin even though Ipamorelin did nothing for me?



Is cardio inherently important here to getting rid of visceral fat, or can I accomplish the same goal by just being in a deficit?

You'll get synergy with the cardio and calorie deficit - if you can do both, do so.

I can say this, nothing has ever leaned out my mid section more and faster in my life (and I am an old fart now) than a combination of GLP and HGH. I do 30 mins LISS daily, usually 10k steps, and my workouts are very intense and sometimes a bit too long (like my 2+ hour leg day today), but I've done that all before and the effect was nothing like what it is on the GLP-1 and HGH (and some other PED's, but again, ran those all before without the GLP-1 and HGH, nothing like this).

 

[Ghoul]

Tesamorelin is an FDA approved drug with a rock solid history of results. Do you know what it’s prescribed for? VISCERAL FAT reduction.

Yes, you have to incorporate some type of movement or this is very unlikely to work. Overcoming insulin resistance involves muscles becoming accustomed to using free fatty acids for fuel.

If you’re expecting fast results, within a month or two, or you’re going to get demoralized, forget it.

You didn’t get yourself into this fucked condition in a couple months and you’re not getting out that quickly either. You’ve already taken the easier GLP weight loss route and sacrificed precious muscle mass (especially for a pre diabetic who NEEDS lean mass more than someone without high insulin resistance). Don’t repeat that mistake by being impatient.

Do you know what the usual fate is of 20 somethings with pre-diabetes?

I’m going to be blunt, the odds of you reversing pre-diabetes are stacked against you. I just gave you the magic wand you need to tilt the odds back in your favor more than anything else could. Tesa and cardio, But understand this. If you fail to dedicate yourself now, after 25 the odds of reversing prediabetes permanently start to drop like a rock.

So either jump on the chance to turn this around by steeling yourself for daily injections of Tesa 2mg for 6 months, and figure out how you can take a brisk walk a few times a week, or accept life as a typical GLP using diabetic, SOFI (skinny outside fat inside), with a long runway of times to develop, in slow motion, all the wonderful things diabetes holds in store for you. Neuropathy, early cognitive decline, and eventually some kind of lonely incapacitation leaving you on the couch to develop bedsores while watching 18 hours of TV a day.

 

[RockyP]

Ghoul is right. Diabetes is an ugly fucking disease and it’s totally preventable and fixable with these sorts of changes (not type I but that’s not what we’re talking about). Not to be histrionic but this is that one shot from the Eminem song. Take the opportunity. Make this a distant memory.

 

[Ghoul]

You'll get synergy with the cardio and calorie deficit - if you can do both, do so.

I can say this, nothing has ever leaned out my mid section more and faster in my life (and I am an old fart now) than a combination of GLP and HGH. I do 30 mins LISS daily, usually 10k steps, and my workouts are very intense and sometimes a bit too long (like my 2+ hour leg day today), but I've done that all before and the effect was nothing like what it is on the GLP-1 and HGH (and some other PED's, but again, ran those all before without the GLP-1 and HGH, nothing like this).

Unless he gets A1C way down first, rHGH, especially the dose he’ll need for it to be effective in his state of “GH resistance”, the result of pre-diabetes and inflammation, has a very real risk of pushing him over the cliff into full blown, irreversible diabetes.

It’s rarely used with pre-diabetics because of this, and when it is, has to be very tightly managed by an endocrinologist to avoid inducing diabetes.

 

[RockyP]

Unless he gets A1C way down first, rHGH, especially the dose he’ll need for it to be effective in his state of “GH resistance”, the result of pre-diabetes and inflammation, has a very real risk of pushing him over the cliff into full blown, irreversible diabetes.

I totally mis read his original post. I missed the “Vs” and his A1C. Agree he should
Not be using HGH in this metabolic state.

 

[Middus]

Since this is my first post on the forum, I will include my background:
Age: mid 20s male
Height: 5'7
Weight: 143 currently
Exercise: weights 3x a week (couple years), and walk a couple miles a day

Was 170 lbs 8/1/2025 and had bloodwork done.
Triglycerides: 116

Total Cholestrol: 220

HDL: 46

LDL: 151

HbA1c: 5.8

Fasting insulin: 15

IGF-1: 180
ALT: 98

Diagnosis: insulin resistant/prediabetic. I started retatrutide and dropped to 138 lbs by 11/3/2025. I got very lean everywhere except my abdominal area. I also lost a shit ton of strength, and probably muscle. I thought this was just glycogen depletion from being so low carb, but even a month after stopping reta and eating more carbs the strength loss is still there.

Question: Is it possible I still have a lot of abdominal fat because of low endogenous GH production? I don't really feel like it's healthy for me to lose any more bodyfat, but I also don't understand how I simultaneously have love handles while being lean everywhere else.

Just wondering why your glucose was heading that direction at a young age despite just being overweight.. Were you just told to lose weight of were extra tests ordered? (this is unimportant. Just my curiosity)

However, you might need to repeat the blood work else we'll just be speculating as to the cause of what is going on.
For instance, if you are still insulin resistant it may explain the persistent abdominal fat

The human body is a complex balance. When your insulin is persistently high, Insulin becomes the main driver of IGF-1 levels in the body. The high insulin causes your body to slow down GH production (via raised IGF-1 levels feedback mechanism). Oddly enough this also sharpens your liver's GH receptors and they become more sensitive to GH.

Controlling your glucose metabolism (with reta) may have altered the balance somewhat (in terms of IGF levels, and GH levels & sensitivity) but only new labs will give you a clearer picture of what's happening.

 

[cousinmuscles]

Can't get better responses than the above!

Can you post your diet?

 

[RockyP]

Can't get better responses than the above!

Can you post your diet?

There are also genetic components at play. That blood work at his age at only 170 lbs and 5’7” is a bit unusual.

 

[BimbapLover]

There are also genetic components at play. That blood work at his age at only 170 lbs and 5’7” is a bit unusual.

I did not mention this, but I do have a family history of T2 diabetes. Though we don't know if it is entirely genetic or environmental. I am first-generation Indian; my grandmother and all her sisters got T2 Diabetes later in life (mid-40s). But their diet was mostly carbs and no protein.

Just wondering why your glucose was heading that direction at a young age despite just being overweight.. Were you just told to lose weight of were extra tests ordered? (this is unimportant. Just my curiosity)

However, you might need to repeat the blood work else we'll just be speculating as to the cause of what is going on.
For instance, if you are still insulin resistant it may explain the persistent abdominal fat

The human body is a complex balance. When your insulin is persistently high, Insulin becomes the main driver of IGF-1 levels in the body. The high insulin causes your body to slow down GH production (via raised IGF-1 levels feedback mechanism). Oddly enough this also sharpens your liver's GH receptors and they become more sensitive to GH.

Controlling your glucose metabolism (with reta) may have altered the balance somewhat (in terms of IGF levels, and GH levels & sensitivity) but only new labs will give you a clearer picture of what's happening.

And when I had my bloodwork, the doc said I needed to lose weight and change diet (eat more fiber/less carbs)

 

[BimbapLover]

Can't get better responses than the above!

Can you post your diet?

During the reta cycle and right now I'm eating around 100-130 grams of protein. I stopped tracking exact calories when I was on reta, but I was eating very low: 1700 or lower.

Basically I would skip breakfast, then I would either walk or workout. Lunch would be a small meal with a fairlife protein shake. Dinner would be a larger meal with another fairlife protein shake. And I would have like a small snack between those two. That was it.

 

[RockyP]

I did not mention this, but I do have a family history of T2 diabetes. Though we don't know if it is entirely genetic or environmental. I am first-generation Indian; my grandmother and all her sisters got T2 Diabetes later in life (mid-40s). But their diet was mostly carbs and no protein.




And when I had my bloodwork, the doc said I needed to lose weight and change diet (eat more fiber/less carbs)

I was going to ask about Indian heritage. You should also be sure to check your Lp(a) on bloodwork and track it.

 

[BimbapLover]

I was going to ask about Indian heritage. You should also be sure to check your Lp(a) on bloodwork and track it.

My Apo A-1 is 137 and my Apo B is 110. But all of this bloodwork is before my weight loss. I'm assuming my new bodyweight will have better markers since I did lose fat, just not as much as I thought.

 

[RockyP]

My Apo A-1 is 137 and my Apo B is 110. But all of this bloodwork is before my weight loss. I'm assuming my new bodyweight will have better markers since I did lose fat, just not as much as I thought.

They should improve. But watch LpA. That is an isolated risk factor and I’ve seen it very elevated in folks of Indian heritage with these metabolic challenges.

 

[cousinmuscles]

During the reta cycle and right now I'm eating around 100-130 grams of protein. I stopped tracking exact calories when I was on reta, but I was eating very low: 1700 or lower.

Basically I would skip breakfast, then I would either walk or workout. Lunch would be a small meal with a fairlife protein shake. Dinner would be a larger meal with another fairlife protein shake. And I would have like a small snack between those two. That was it.

That's a horrible diet. How about a minimum of 4 meals, preferably 6 meals per day. If 4 meals then 6oz of chicken breast/very lean beef/salmon for protein, if 6 meals then 4oz of each. If egg whites double the weight for equal protein. Potatoes/sweet potatoes/rice/oats for carbs - adjust according to goals and results, in your case start with ~150g carbs. A little veggies with each meal, try to get all colours throughout the week - green, red, yellow, white et.c.

I'll stop there on the nutrition part because everything else is excess information which is not important for now. You have to develop proper eating habits to help build and retain muscle, keep your metabolism running, improve gut health and so on.