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Does Metformin Cause Weight Loss?
Metformin, a potential weight-loss medication, is available to some patients with type 2 diabetes. The question is, how much weight can you really lose with metformin with or without diabetes? What are the mechanisms of weight loss, if any, and is it really worth it considering all the side effects you may experience? Today we will talk about that in detail.
And internet forums are full of stories from folks who have lost weight while using metformin. One person said when asked about being offered metformin, “I had been trying to lose weight for a long time and had no luck.” She said I’d shed 12 pounds by taking 1000 mg every day. “I experienced weight loss with 750 mg twice a day initially.” “The transformation was practically instant.”
Even those who don’t have Type 2 diabetes swear by it. In fact, some doctors give the drug to folks who are overweight or obese even if they do not have Type 2 diabetes, which is an off-label indication.
If you have diabetes, it is true that metformin can help you lose 2.7 kg over four years. On the other hand, rosiglitazone and pioglitazone can make you gain 4.8 kg. A meta-analysis of studies that compared different drugs found that metformin had a big effect on weight at the end of the study compared to sulfonylureas.
Has Metformin Been Studied For Weight Loss?
People who took metformin lost a lot of weight in the Diabetes Prevention Study, which is the largest study to show this (DPP). The DPP looked into how metformin can help people who are at risk for type 2 diabetes keep their metabolic parameters in check. It showed that taking metformin for three years cut the risk of diabetes in these high-risk patients by 31%. The following studies looked at how changes in weight and waist circumference were affected. People who were given metformin lost 2.1 kg on average. Over two years, the more adherent a person was, the more likely they were to lose 3.5 percent of their body weight. People who were less adherent had a higher risk of having a weighted neural status. Weight loss lasted over 10 years for the group that was very strict with their diet. Waist circumference was also affected, with smaller waist circumferences linked to the level of adherence to the plan. The DDP found that weight loss with metformin was long-lasting and safe, except for some mild gastrointestinal (GI) side effects. However, how well the participants kept to their diets was very important.
You should be aware of the metformin’s side effects when using metformin for weight loss, which can be quite unpleasant, for which we have other articles you can learn more.
How Does Metformin Work To Help With Weight Loss?
Current research suggests that the weight change that happens when you take metformin is more likely to be because you eat fewer calories than you burn more. Metformin may have an effect on appetite both directly and indirectly because of its gastrointestinal side effects.
Metabolic acidosis, which happens in many chronic diseases like CKD, is linked to anorexia and protein malnutrition. Metformin is thought to increase lactate production, which as a result can cut your appetite. But you may feel a little sick at the same time due to lactic acidosis in your system.
Also, gut-brain axis modulation of hunger is possible with metformin. Glucagon-like peptide-1 (GLP-1), an incretin that promotes weight loss, and the anorectic hormone peptide YY are both increased by metformin. Do you remember GLP-1 hormones? Ozempic and Rybelsus are also GLP-1 mimetics, meaning GLP-1 mimickers. Metformin has similar hormonal activation to Ozempic or Trulicity but to a lesser degree.
Metformin may make people not want to eat because they may have a bad, bitter, or metallic taste in their mouths because of the high concentration in their oropharynx.
Human studies have shown that it has a positive impact on the microbiota. According to a new double-blind randomized control study, metformin dramatically changed the relative abundance of various bacterial strains. Stool samples were given to mice, who showed improved metabolic parameters after receiving metformin-treated stool. These findings raise the intriguing idea that metformin’s beneficial effects, including its weight-loss effects, are the result of a changed microbiome.
Obesity is a disorder of nutrient homeostasis, but it is also a disease of aging. To learn more about how to reverse aging click here. As people get older, they become more likely to become obese. It’s also common as people get older to have sarcopenic obesity, where fat mass grows while lean body mass shrinks. This has been found to happen a lot, with some elderly populations having a prevalence of up to 15%. Multiple ways are thought to play a role in these possible effects. Metformin is thought to make the mTOR complex less active, which is linked to aging and many aging-related diseases. In humans, it isn’t clear how metformin affects aging. The effects of metformin on muscle mass and strength are being studied in trials. Regardless, metformin’s lowering insulin levels overall can directly help prevent fat gain, indirectly help by keeping you active (since fatter you are harder to move) and, as a result, keep your muscle mass longer.
What is the verdict? Should I take Metformin for weight loss?
Even though metformin has a good safety and tolerability record, with occasional metformin recalls of certain badges by the FDA, it isn’t clear if it should be used as the main treatment for obesity or as a way to lose weight. It may help people who are at risk of metabolic problems or have other problems because of their weight. Its effects on the central hypothalamus, incretin secretion, and the gut microbiome make it a good place to look for new ways to treat obesity. The long-term effects of metformin use on aging and sarcopenia aren’t clear yet, but they could also give us important information about how to keep our bodies in the best shape as we get older. In the meantime, metformin will still be a mainstay treatment for type 2 diabetes, and it will have a lot of other effects on the body that aren’t just glycemic control.
At the end of the day, The FDA hasn’t approved metformin as a weight-loss drug because the effects of weight loss have been small and inconsistent, so they haven’t. Endocrine Society guidelines say that metformin should not be used as a single treatment for obese people who don’t have other metabolic problems like diabetes.
If you want to learn about other topics such as would metformin affects other drugs you are taking read this comprehensive article about metformin.
About the author: Dr. Ahmet Ergin is the author of The Ultimate Diabetes Book and the Founder of the SugarMD youtube channel. He practices in Port Saint Lucie, FL as an endocrinologist physician.