Does Metformin Cause Weight Loss?

Metformin, a type 2 diabetes medication, has been approved by the U.S. Food and Drug Administration to be used in treating high blood sugar or hyperglycemia.

Minisha, MD, an endocrinologist certified in New York City, says that Metformin is considered to be a first-line drug in treating type 2 diabetes. It also aids a hormone called insulin in working better, by helping the muscles to use glucose more efficiently. A person's insulin levels will drop if insulin functions better and their insulin sensitivity is higher.

There's no cure for type 2 diabetes, but the right combination of medication and a healthy lifestyle can stabilize blood sugar levels, according to the Mayo Clinic, and in some cases even put type 2 diabetes in remission, according to a study published in Nutrients in April 2019. This is, however, the goal of all diabetes treatments.

According to the Cleveland Clinic, the medication can help lower your blood sugar level and increase your insulin responses. This will make you feel healthier and may also reduce future complications such as diabetes, heart disease, neuropathy or nerve damage.

Metformin causes weight loss

Although the relationship between weight and metformin is not clear, there are many theories that could explain weight fluctuations.

Metformin, for example, may alter hunger cues. In one small study, 12 women with obesity and type 2 diabetes who were not taking insulin were randomly given two dose levels of metformin - 850 milligrams (mg) or 1,700 mg - or a placebo three times a day for three days, with each participant going through the study three times so they had each dose and the placebo. Each participant was given a meal test, and they were asked how hungry they felt before eating. Research showed that the hunger levels of the metformin-treated group were lower than those who received the low dose (1,700 mg) or the placebo.

Another study, published in May 2020 in the journal Diabetes Care, found that when participants increased their metformin dose by 1,000 mg or more, they lost significantly more weight than those who didn't change their metformin dose or decrease their dose. Emerging research reported in journals including Current Obesity Reports suggests metformin may also lead to weight loss as a result of changes in the appetite centers of the brain, shifts in the gut microbiome, and reversal of metabolic changes that usually happen with age.

You may also experience side effects that can impact your food intake. Rahaf al Bochi RDN (a Baltimore-based media spokesperson and the owner of Olive Tree Nutrition) says that metformin can cause gastrointestinal side effects such as nausea and diarrhea.

According to a study published in the April-June 2017 Journal of Research in Pharmacy Practice, gastrointestinal side effects are a primary complaint from those who receive metformin tablets in their original formulation. Most people who take metformin tablets in their original formulation experience nausea, vomiting and diarrhea. These symptoms can affect between 2 and 63 percent. The discomfort can become so severe you might not want to eat as much, and consequently consume less calories. The extended-release forms of metformin have fewer documented side effects, according to a past review.

Metformin: Is it possible to lose weight long-term?

Although metformin might lead to weight loss, it may cause you to lose far more than what you expect. On average, weight loss after one year on the drug is only six pounds, according to past research.

According to Dr. Sood, metformin may be given to high-insulin people who struggle losing weight. If you eat too much and live asedentary lifestyle, expect to see a drastic change in your weight. For significant weight changes to occur, it is important that you follow a weight loss strategy with healthy eating habits and regular exercise.

She says that metformin won't result in weight loss if someone doesn't have healthy lifestyle habits. To get the most out of metformin, it is crucial to have a healthy lifestyle that doesn't include refined sugars or carbohydrates.

While the weight of your body may fall while on this drug, it is possible that this temporary loss will be permanent. After stopping taking this drug, your appetite may return to normal and you could gain weight.

And yet one study, published in May 2019 in the Annals of Internal Medicine, did find that people in the diabetes prevention program who lost at least 5 percent of their body weight after a year were more likely to maintain the weight loss long term if they were in the metformin group than if they were assigned a placebo or a lifestyle intervention.

Metformin is safe for people with diabetes.

But what if you aren't diagnosed with type 2 diabetes? What if you don't have type 2 diabetes? Can metformin be used to lose weight? It's a great question. The short answer to it is "Yes."

Sood explained that metformin was used for weight management by people who don't have type 2 diabetes, but it has also been used outside of its approved purpose.

There is evidence that metformin might be beneficial to these people: An 2018 study examining metformin's effectiveness in weight loss for overweight or obese individuals without diabetes found that it significantly reduced body mass (BMI), both in adults and adolescents.

Keep in mind, however that the drug can only be prescribed and not FDA approved by people with type 2 diabetes. Most likely, your doctor will recommend these traditional weight loss strategies:

Your doctor could approve this drug even if your condition is not type 2. Metformin can't be used to replace healthy eating habits and exercise. These are key factors in sustainable weight loss. These lifestyle habits will encourage weight loss even if you don't have metformin.

Al Bochi states that some individuals may have a difficult time with metformin.

You should think about lifestyle and diet modifications. Al Bochi says that diet modifications include paying attention to your carbohydrate intake and choosing foods high in fiber. For tailored nutritional recommendations, she recommends that you consult with a registered dietitian. Al Bochi states that it is important to include some movement in your daily life, including weight training or walking.

Metformin and weight loss: the bottom line

Metformin may cause weight loss in people who have diabetes or not. Nonetheless, scientists are still studying why the drug has this effect. There are many factors that could be at play, including the side effects of the drug, which can cause an appetite decrease.

The truth is that metformin doesn't provide a miracle cure. You can lose weight whether you are trying to control type 2 diabetes, or any other reason. The best thing to do is make lifestyle and dietary changes. Metformin is a sidekick for these steps.

Keep in mind, however that metformin is currently only approved by the FDA for people suffering from type 2 diabetes. It has not been approved for anyone else. Metformin can be used to lower blood sugar if you have diabetes. You will need to talk to your doctor about side effects.

Additional reporting by Leslie Barrie.