Calories in, calories out. I’ve only discussed weight loss medications with physicians as a way to treat PCOS, IR resistance and diabetes adjacent conditions. Lose weight is always the answer, even if weight loss methods don’t work due to diabetes adjacent conditions. Maybe because you already have diabetes you haven’t encountered this, I don’t know. But I’ve attempted to prevent it from progressing to diabetes for years while I watched by bloodwork and symptoms steadily reach near diabetic levels. If my levels were just a bit higher they’d treat the diabetes. I’ve even been told it would be a whole different world of treatment options when I’m there and it will improve my PCOS and IR etc.