Taking diabetes medication for weight loss might seem like a disconnect. But many of the go-to prescriptions used to treat type 2 diabetes such as metformin, SGLT2 inhibitors, or GLP-1 receptor agonists—have also been shown to include weight loss as a side effect. You may recognize some common GLP-1s such as Ozempic®, Trulicity®, Rybelsus®, or the SGLT2 inhibitor empagliflozin. Health care professionals can prescribe drugs like metformin off-label to treat overweight and obesity. Off-label prescribing is a common practice when medications approved for one condition can also help others.
And there’s been a paradigm shift leading to new American Diabetes Association (ADA) guidelines that emphasize losing 15 percent of your body weight as a primary goal to treat type 2 diabetes, which often coexists with obesity. (The prevalence of type 2 diabetes is three to seven times higher in people with obesity compared to those without obesity.)
But how exactly does a diabetes medication work for weight care, you ask?
Metformin differs from older-generation diabetes meds that worked by increasing insulin secretion (promoting hunger and weight gain.) It works like this: Metformin improves glucose uptake in muscles and fat tissue and acts as an insulin sensitizer. It improves insulin sensitivity and allows your cells to process glucose more efficiently by lowering both sugar absorption and glucose production. As a result, it can decrease appetite and reduce fat storage. How so? By upping the satiety hormone glucagon-like peptide 1 (GLP-1) secretion so you may feel fuller faster–helping with weight loss.
A study published in Diabetes Care found that people taking metformin lost three to four percent of their total body weight compared to those given a placebo—who had little to no change in their weight after two years. And when the researchers followed up over the course of the next six years, the weight loss among the metformin group remained significantly greater compared to those taking the placebo. In fact, participants on metformin showed sustainable weight loss lasting at least ten years.
GLP-1 medications, like Ozempic, are another type of diabetes drug that can help with weight loss. But they differ from metformin in that they control blood sugar levels by mimicking the role of your body’s natural GLP-1 hormones (instead of increasing them)—which stimulates insulin secretion and lowers blood sugar. And yes, like metformin, this medication can help you feel fuller faster, leading to reduced appetite, fewer cravings, and improved portion control. Most GLP-1s are injectables, and they’ve been approved by the FDA to treat type 2 diabetes and obesity and overweight. Now, there’s no magic pill for weight loss; however, a study of adults with overweight and obesity published in the New England Journal of Medicine found that participants who took once-weekly semaglutide (a GLP-1) and made lifestyle changes lost almost 15 percent of their body weight compared to three percent in the placebo group. And that also meets the ADA guideline for treating type 2 diabetes. It's important to know GLP-1 medications have the potential for both minor and more serious side effects. Common side effects include nausea, vomiting, diarrhea, and acid reflux. More serious but less common side effects include pancreatitis, gallbladder disease, and worsening of diabetic eye disease. You should not use these drugs if you have a personal or family history of medullary thyroid cancer or multiple endocrine neoplasias. You can find detailed side effect and risk information for specific GLP-1 medications here.
Yes, if it’s right for you. Our medical team will assess your unique needs and prescribe appropriate treatments, which may include metformin for weight loss. Found offers personalized treatment plans to help people with obesity achieve sustainable weight loss with the support of prescription weight care medication.
GLP-1 prescriptions, filled through your local pharmacy, are now available as part of Found's weight-loss toolkit. While GLP-1s are effective for weight loss, they are not clinically appropriate for everyone. Eligibility for a GLP-1 is based on a thorough evaluation of your medical history, eating behavior, lab work, and insurance coverage. If a GLP-1 is not appropriate for you, our providers will work with you to determine an effective medication for your health profile.
Found is among the largest medically-supported weight care clinics in the country, serving more than 200,000 members to date. To start your journey with Found, take our quiz.