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Progressive overloadgradually increasing weight, repetitions, or exercise difficultyprovides the stimulus necessary to preserve and potentially build muscle despite caloric restriction

This is because bones strengthen in response to bearing weight

Metformin acutely lowers blood glucose levels by inhibition of intestinal glucose transport

By starting with a low dose and incrementally increasing it over several weeks or months, your body has time to acclimate, which improves tolerability and helps ensure you can continue treatment effectively towards a maintenance dose

However, you should inform your healthcare provider about your surgical history before starting