a few questions I see repeatedly, answered as someone whose fasting insulin was 22 at age 23 and who’s been actively managing it since: does tirzepatide have longevity benefits beyond weight loss?
probably, but not bc of the weight. the mechanism that matters is insulin sensitization. chronic hyperinsulinemia accelerates basically every pathway the longevity crowd obsesses over: mTOR dysregulation, AGE accumulation, systemic inflammation. fixing the insulin upstream is the intervention. the weight loss is downstream of that. is metformin worth it for longevity if you’re not diabetic?
the research is genuinely interesting (TAME trial, etc.) but people without insulin resistance are likely getting marginal benefit. if your HOMA-IR is above 2.0, different conversation. what markers actually matter?
fasting insulin and HOMA-IR over A1C, at least until A1C starts moving. A1C is a lagging indicator. fasting insulin tells you what your pancreas is doing right now. the tech bro longevity discourse spends millions on exotic interventions while ignoring that a huge percentage of women are running an involuntary metabolic aging experiment their whole lives and nobody’s studying them. that’s the actual gap.