Metformin for weight loss or diabetes ?

Although metformin can cause weight loss, a healthy diet and regular exercise are still necessary to maintain weight loss.
If you’re using metformin (Glucophage) to treat type 2 diabetes, you may be familiar with its undesirable side effects, including stomach upset, diarrhoea, muscle aches, and drowsiness. Metformin’s side effects can be a literal and figurative pain, but if you’ve struggled to lose weight, you might welcome one of them with open arms.

Metformin is not a drug for weight loss, but researchers have discovered a connection between the drug and weight loss. A long-term study conducted by the Diabetes Prevention Program and published in the journal Diabetes Care concluded that the drug could be used to treat obesity, although additional research is required.


What Exactly Is Metformin and How Does It Function?

 

Metformin is considered a first-line treatment for type 2 diabetes, and it primarily works by reducing the amount of glucose released by the liver, according to Minisha Sood, MD, an endocrinologist based in New York City. “It also helps a hormone called insulin function more effectively by increasing the efficiency with which muscles utilise glucose. When insulin functions more effectively and insulin sensitivity increases, a person’s insulin levels are lower than they would be otherwise.”

There is no cure for type 2 diabetes, but a combination of medication and a healthy lifestyle can stabilise blood sugar levels, which is the ultimate goal of any diabetes treatment.

As the medication helps your body properly metabolise glucose from the breakdown of food and restores your ability to respond to insulin, not only will you feel better, but you may also be able to avoid complications of high blood sugar, such as heart disease, kidney damage, nerve damage (diabetic neuropathy), and eye damage (retinopathy).

 

Why does Metformin cause weight reduction?


Several hypotheses offer potential explanations for fluctuations in weight despite the absence of a clear relationship between metformin and weight. According to the Mayo Clinic, one of the documented side effects of metformin is decreased appetite.


For instance, metformin may alter hunger signals. In one small study, 12 obese women with type 2 diabetes who were not taking insulin were randomly assigned to receive one of two doses of metformin — 850 milligrammes (mg) or 1,700 mg — or a placebo three times a day for three days, with each participant receiving each dose and the placebo three times. On every third day, participants completed a meal test and rate their hunger level prior to eating. Researchers discovered that hunger levels were significantly reduced in the metformin group, especially after participants took the 1,700 mg dose compared to when they took the lower dose or placebo.

If you take metformin, it may not appear as though you are eating less. However, it’s possible that the number of calories you’re consuming for breakfast, lunch, and dinner is lower than usual. This subtle shift in appetite may be responsible for a slow weight loss.

Frequent stomach upset or diarrhoea, which is another side effect of the medication, can also affect your food intake.

According to a study published in the April–June 2017 issue of the Journal of Research in Pharmacy Practice, those who take metformin tablets in their original formulation most frequently report gastrointestinal side effects. Vomiting, diarrhoea, and nausea are the most common side effects, affecting between 2 and 63 percent of people taking the drug. It is possible for discomfort to be so severe that you lose your appetite and consume fewer calories. Studies have found that the extended release forms of metformin have fewer side effects.

Metformin is associated with a lower risk of death from COVID-19 in individuals with type 2 diabetes.

 

Metformin and long-term weight loss: Is it possible?


Even though metformin can assist in weight loss, the amount lost may be considerably less than anticipated. According to a study published in Diabetes Care, the average weight loss after one year of medication is only 6 pounds.

Dr. Sood explains that while metformin is commonly prescribed to people with high insulin levels who have difficulty losing weight, it is not a panacea for weight loss. In other words, do not anticipate a significant weight loss if you overeat and lead a sedentary lifestyle. To achieve significant weight loss, you must adhere to a sensible weight-loss programme that includes healthy eating and physical activity.

“Taking metformin will not result in weight loss if a person does not practise healthy lifestyle habits,” she explains. “If [you are] prone to high insulin levels, it is essential to follow a healthy diet low in refined sugars and carbohydrates in order to receive the maximum benefit from the medication.”

Keep in mind that while taking this medication, the number on the scale may decrease, this weight loss may be temporary. Once you stop taking the drug and your appetite returns to normal, you may gain weight; therefore, it is essential to maintain a healthy lifestyle.

If you are considering combining metformin with a medication for weight loss, consult your physician for guidance. Sood asserts that this combination may aid in weight loss and maintenance, despite the lack of clinical trial evidence to support this claim.

 


What if you do not have diabetes type 2?

 

Can metformin still be used for weight loss? This is a very good question, and the answer is yes. Sood explains that metformin has been used off-label, or for a purpose other than its intended one, for weight loss.

In fact, according to a study published in December 2018 in the European Journal of Clinical Pharmacology on the effectiveness of metformin for weight loss in overweight and obese individuals without diabetes, the drug could significantly reduce body mass index in both adolescents and adults.

  • Avoid sugary drinks.
  • Consume water prior to meals to fill your stomach and eat less.
  • Most days of the week, exercise for 30 minutes.
  • Prepare whole foods such as vegetables, fruits, and grains.
  • Reduce your consumption of processed foods.
  • Consume a diet high in protein, low in carbohydrates, and low in fat.
  • Practice portion control.
  • If you’re obese and struggling to lose weight but do not have type 2 diabetes, your doctor may approve this medication. However, metformin is not a replacement for healthy eating and regular exercise, which are essential for long-term weight loss. If you have type 2 diabetes and are unable to take metformin, these behaviours also promote weight loss.

Conclusion Regarding Metformin and Weight Loss


Metformin can cause a modest weight loss, most likely due to its side effects, which include a decreased appetite and an upset stomach. However, although the drug is effective for weight loss, it does not replace conventional dieting methods. Therefore, if you want to lose more weight and keep it off for longer, you must be active and eat well.

 

Sources

Pharmacy practice journal (NHS) [June 2017] [reviewed 13/06/2022]

European Journal of clinical pharmacology [december 2018 ] [reviewed 13/06/2022]

NHS Metformin  [reviewed 13/06/2022]

Reviewed by Doctor Colin Galloway on 13/06/2022

Dr. Galloway has over 15 years of experience as a Cardiology and General Medicine consultant. He is a graduate of University College London.

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