Metformin Weight Loss: What to Know

Key Takeaways

Metformin is commonly prescribed for lowering blood sugar and achieving glycemic control in people with type 2 diabetes and pre-diabetes. However, metformin may be considered for chronic weight management in non-diabetic individuals.
Metformin appears to affect appetite and food intake, decreasing food consumption rather than increasing energy expenditure. However, keep in mind that metformin is not among the FDA-approved anti-obesity medications.
Metformin is also effective in counteracting weight gain due to medication side effects, for example, antipsychotic-induced weight gain. According to studies’ findings, you may expect to lose more than 5% of your baseline body weight on metformin within the first year.

Metformin is a commonly prescribed oral medication for lowering blood sugar and achieving glycemic control in people with type 2 diabetes. Along with healthy eating and exercise, this drug helps to lower blood glucose levels by reducing glucose production in the liver. It also improves the way the body uses insulin (increases insulin sensitivity and decreases insulin resistance) while reducing glucose absorption in the stomach and intestines.

Clinical trials have shown that patients on metformin therapy experience modest weight reductions. However, metformin’s exact mechanism of weight loss is unclear. It is theorized that metformin stimulates the release of appetite-suppressing hormones due to its effects on the gut microbiota. Another factor to be considered is the gastrointestinal tract side effects of metformin. Nausea, stomach upset, and diarrhea are common side effects of metformin. These unpleasant effects on the gastrointestinal tract can be so severe that people may not want to eat, leading to lower calorie intake and weight loss.

Due to metformin’s inconsistent effects on weight loss, the U.S Food and Drug Administration (FDA) has not approved metformin for chronic weight management in non-diabetic individuals.

Please continue reading to learn more about metformin for weight loss, including how much weight you can lose with metformin or lifestyle intervention.

Why do some people lose so much weight on metformin?

Evidence suggests that the weight loss associated with taking metformin is likely due to decreased caloric intake. In other words, metformin decreases food consumption rather than increasing energy expenditure. Metformin use appears to affect appetite and food intake both directly through effects on the gut microbiome as well as indirectly because of gastrointestinal side effects.

Can I lose 30 pounds on metformin?

Losing 30 pounds on metformin monotherapy may not be possible. Weight changes on metformin are modest at best. Studies have shown that approximately one-third of people who took metformin lost more than 5% of their baseline body weight in the first year. In terms of long-term results, at the 15-year follow-up, the average weight loss compared to baseline weight was 6.2%.

People with prediabetes were enrolled in the Diabetes Prevention Program (DPP) trial and received either intensive lifestyle modifications, metformin at a dose of 1,700 milligrams (mg)/day, or a placebo. The primary outcome measured was whether metformin could reduce body weight to prevent or delay the onset of type 2 diabetes in high-risk individuals. The average body weight of the participants was 94.2 kilograms (kg) or about 207 pounds, and the average body mass index (BMI) 34 kg/m2.

At the initial 2.8-year follow-up, people in the lifestyle intervention group lost 5.6 kg (12 pounds) on average. Those who took metformin had an average weight loss of 2.1 kg (4.6 pounds). People who received the placebo lost 0.1 kg (less than 1 pound) on average.

However, unlike the weight loss achieved with a healthy lifestyle alone, patients treated with metformin lost significantly more weight and maintained the weight loss throughout the follow-up periods. The people in the metformin group had an average weight loss of -2.5 kg (5.5 pounds) over time, whereas those in the lifestyle intervention group regained the weight.

How much weight can you lose on metformin?

You can expect to lose about 5% of your baseline body weight on metformin. Therefore, for example, if you weigh 250 pounds at baseline, you can expect to lose 12-15 pounds from the beneficial effects of metformin. Lifestyle modifications, such as a healthy diet and exercise, are essential to maintain, in addition to the effect of metformin. Just like with any weight management therapy, lifestyle modifications are important to achieve and maintain weight loss.

Does metformin reduce belly fat?

A randomized controlled trial called the Biguanides and Prevention of the Risks in Obesity (BIGPRO) enrolled people with abdominal obesity (belly fat or upper body fat distribution). The study participants did not have diabetes. The criterion to be included in this trial was a high waist-to-hip ratio rather than body mass index (BMI). Participants received either metformin 1,700 mg/day or placebo for obesity treatment. At the 1-year follow-up, the metformin group compared favorably with the placebo group (2 kg in the metformin group versus 0.8 kg in the placebo group).

How quickly will you lose weight on metformin?

As mentioned, metformin is not approved by the FDA as a weight loss medication. While trials have shown that people who take metformin have lost weight one year after starting metformin treatment, metformin is not a magic pill for weight loss. Lifestyle modifications with healthy diets and exercise are crucial for any type of weight management therapy.

Can I take metformin to reduce body weight if I don’t have diabetes?

Metformin is not among the FDA-approved anti-obesity medications. Experts do not usually recommend metformin for obese individuals who do not have metabolic abnormalities such as diabetes.

However, the Diabetes Prevention Program trial (DPP) and the Diabetes Prevention Program Outcomes Study (DPPOS) concluded that weight loss with metformin is possible in people who do not have type 2 diabetes. Metformin may help with weight loss in obese individuals with a BMI of 30 or above who don’t have type 2 diabetes. This drug has a long-term safety record but may not be safe for people with certain health conditions, such as kidney disease.

Metformin is also effective in counteracting weight gain due to medication side effects, for example, antipsychotic-induced weight gain.

If lifestyle changes have not resulted in significant weight loss, talk to your doctor about taking metformin for weight loss. It may help you achieve a significant reduction in body weight, lowering your risk of type 2 diabetes. Diabetes is a chronic condition associated with many health risks, including an increased risk of metabolic complications and heart disease.

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