There’s been a ton of buzz around metformin weight loss for years. It’s one of the most widely prescribed drugs for type 2 diabetes in the United States—but the current hype has to do with research that shows it may help with weight loss too.
Let’s talk about the diabetes piece first. According to a 2017 editorial in Diabetologia, metformin was “the eighth most commonly prescribed drug consistently from 2008 to 2012, [with] the number of prescriptions rising from 51.6 million in 2008 to 61.6 million in 2012.”
The global health burden of diabetes has increased substantially from 2000 to today. Additionally, of the two kinds of diabetes, 90%-95% of Americans are diagnosed with type 2 diabetes. This is when a person develops insulin resistance or has a reduced capacity to produce insulin and cannot naturally lower their blood sugar levels.
Patients must treat type 1 diabetes with insulin, but they can often manage type 2 diabetes with healthy lifestyle changes, like diet and physical activity, diabetes medications, or insulin therapy if necessary.
The diabetes crisis is dire, with diabetes attributing to 1.5 million deaths per year, according to the World Health Organization. This makes it the ninth leading cause of death worldwide. But metformin treatment for diabetes management has greatly impacted healthcare for its ability to help save lives.
Metformin has been used clinically for over 60 years. It was widely studied from 1960 to 1980 to verify its efficacy in lowering blood glucose levels, eventually becoming the “‘optimal’ therapy in type 2 diabetes,” according to Diabetologia.
The U.S. Food and Drug Administration (FDA) approved metformin to treat type 2 diabetes in 1994. And while it's proven to be a very effective diabetes drug over the years, there’s still research on metformin weight loss. Here’s what we know about it now.
Although it’s FDA-approved for diabetes, doctors also prescribe metformin off-label as a weight loss drug. Why? A novel 1998 study explored the effects of metformin on women with obesity and non-insulin-dependent diabetes mellitus (NIDDM)—meaning people who had diabetes but didn’t need insulin. It found that the medication also helped reduce body weight. among the 48 participants who hadn’t successfully lost weight after changing their diet. During the metformin trial, they were either put on an American Diabetes Association-approved calorie-reduced diet and given either an 850-gram dose of metformin or a placebo twice a day.
The clinical trial results were outstanding. Researchers discovered that the medication can trigger feelings of fullness and reduced appetite, reducing calorie intake. After 24 weeks, the average body weight of those on metformin dropped by about 17 pounds more than the placebo group—evidence that weight loss is possible on metformin.
A Diabetes Prevention Program Research Group study also showed that metformin weight loss works. In addition, it determined that long-term treatment was safe and helped sustain weight loss for at least 10 years.
Moreover, when participants in the same trial routinely took metformin—even with no healthy behavior changes—they lost the most weight and body fat. However, the placebo group lost no weight, suggesting that the success of weight loss could be attributed to metformin — not lifestyle changes. Additionally, according to the study, metformin “lowers glucose and reduces risk for diabetes in part through weight loss.”
Research points toward metformin as a powerful weight-loss tool. And after speaking with your doctor at Found, you may be prescribed metformin for weight loss if you’re a candidate. But know that prescribing medications is up to a medical provider’s discretion and metformin may not be right for everyone.
2Metformin may also have other health benefits, including possible cardiovascular health improvement. For example, because it lowers blood sugar, it may lead to reduced risks of heart attack and stroke. But research is ongoing, and a 2017 review of studies published in Diabetologia noted that while there is a suggestion that metformin is beneficial, “there remains uncertainty about whether it reduces risk of cardiovascular disease.”
Another possible health benefit is the easing of symptoms associated with polycystic ovary syndrome or PCOS. This hormonal disorder can cause enlarged ovaries with small cysts and may lead to infertility. Insulin resistance is thought to be a key factor in PCOS development. PCOS isn’t just a reproductive disease either—it can lead to type 2 diabetes and endometrial cancer, among other long-term, life-threatening diseases. Metformin’s ability to lower blood glucose levels can help with insulin resistance in PCOS patients. It’s important to note that metformin and PCOS studies are in their infancy, and more research is needed.
Metformin also helps with the effects of antipsychotic weight gain. According to a 2016 meta-analysis examining 12 studies with a total of 743 patients published in BMC Psychiatry, patients treated with metformin and atypical antipsychotics showed a significant reduction in Body Mass Index (BMI) and significantly more weight loss when compared to those patients who were given a placebo.
All of this research supports metformin as a therapeutic medication and is valuable across multiple conditions in reducing symptoms and aiding in treating diseases.
All medications have risk factors, but the consensus is that metformin is safe to use for weight loss, even if you don’t have diabetes. If you experience adverse side effects, they’ll typically lessen within a few weeks. The most common side effects include mild gastrointestinal issues—like diarrhea—but they usually don’t outweigh the benefits of using metformin for weight loss.
During the Diabetes Prevention Program Outcomes Study (DPPOS) conducted by the Diabetes Prevention Program Research Group, metformin produced weight loss in participants with obesity and pre-diabetes without significant safety issues. However, the authors noted that “participants reported more gastrointestinal symptoms than placebo participants, however, these abated over time and both types of gastrointestinal symptom reports were similar between groups by the latter years of the DPPOS.” This suggests that regardless of metformin use, those candidates who didn’t even take the medication still experienced stomach issues later in the study.
4Various studies have given different doses of metformin before, after, and even with meals. Most commonly, Found healthcare providers recommend taking it right before bed to prevent any possible nausea or with a meal to avoid an upset stomach.
Your doctor can give you personalized guidance on when to take it. If you’re experiencing symptoms when taking it before a meal, your Found physician may switch it up to help alleviate some of those side effects. It’s important to follow your doctor’s instructions and listen to your body.
Also, if you’re prescribed metformin, share any feedback you have while taking it so your Found physician can devise the best possible solution for you.
Of course, the amount you need to take depends entirely on you, and your Found healthcare provider will help you decide your plan with thorough vetting. Patients with obesity have been given up to 2,500 mg, which was safe and effective in metformin weight loss efforts. Think of it like this—it’s typically a rule of thumb to begin at a lower dosage level and then steadily increase the dose to figure out how it’s working and how well your body tolerates it.
The short and truthful answer is, no. The effects of metformin weight are promising in weight loss, but physical activity, a healthy diet, and lifestyle changes are fundamental in maintaining your weight-care journey. It must also be continually taken over a long period to sustain your results and support ongoing weight loss.
There are other reasons that metformin needs to be taken in combination with behavior and habit changes for long-term weight care. According to a June 2022 announcement by the Endocrine Society, a new study found that “overweight and obese people maintained an average weight reduction of 10.6% over 3 to 5 years with a program of lifestyle changes combined with anti-obesity medication.”
But how about we pause here in the present? The current research on metformin weight loss is encouraging because the drug can not only be used to help treat overweight and obesity, but it's also proven safe and effective. All big wins in our book!
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