Metformin’s effect on weight loss is not new. In doing my research on PubMed, I found a study published in the Diabetes Journal, 2012 “Long Term Safety, Tolerability, and Weight loss Associated with Metformin in the Diabetes Prevention Program Outcomes Study.” I like this study as it had over 2,000 patients, was a double blind placebo study, and they followed patients for 10 years.
Study:
- Double blinded 1,000 in each arm- metformin 850 BID vs. Placebo
- BMI 24 or higher and blood glucose 95-125
Findings:
- Statistically significant more weight loss and decrease in waist circumference in the Metformin group.
- The degree of Metformin adherence was important to having sustained weight loss
- They conclude: “For diabetes prevention it is safe and well tolerated. Weight loss is adherent to metformin and is durable for 10 years of treatment.” They do state that all groups after 2 years had increase in their abdomen measurement except for the highly adherent Metformin group.
I found it interesting that it states in prevents diabetes progression in 1/3 of patients who took it.
How does Metformin work?
They cite many ways:
- Metformin lowers glucose and reduces risk for diabetes in part through weight loss
- baseline energy expenditure does not change
- Metformin weight loss decreases fat with little change in lean tissue. (This differs from the pattern seen with caloric restriction)
- Metformin has several effects on energy metabolism that parallel physical exercise–stimulate phosphorylation of AMP-activated protein kinase (AMPK) an important regulator of mitochondria, hepatic and muscle fatty acid oxidation, glucose transport, insulin secretion, and fat creation.
- Reduced food intake owing to irritation of the GI tract (nausea/diarrhea)
They do state it doesn’t lower blood sugar. I am a plastic surgeon, not an internist, so I don’t know if there are contraindications to who can try metformin. But for those who have elevated levels and are in the pre-pre-diabetic group, pre-diabetic, or diabetic groups, Metformin seems to have a lot of benefits.
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