Metformin is one of the first treatment options considered for people with type 2 diabetes to help manage glucose levels. Although it is not a weight loss drug, there is research suggesting it may lead to modest weight reductions.
Considering all factors, metformin can cause a modest amount of weight reduction in those who take the medication regularly, although average weight loss is only between 4-7 pounds per year.
Is Metformin an Effective Weight Loss Pill? No. The amount of weight you're likely to lose is low. In one diabetes prevention study, 29% of people lost 5% or more of their body weight and just 8% lost around 10%.
The average weight loss in the group that received metformin was 5.8 kg (12.8 lbs) ±7 kg (± 15 lbs). Untreated controls gained 0.8 kg (1.8 lbs) ± 3.5 kg (± 7.7 lbs) on average. Patients with severe insulin resistance lost significantly more weight as compared to insulin sensitive patients.
Metformin and weight loss
In a much larger trial in over 4,000 people with type 2 diabetes, it was found metformin use was associated with a 2.4 kg (roughly 5.3 lbs) weight loss over a four-year period. There are a few ways that metformin might impact weight.
For extended-release metformin and tablets, doses are between 500 and 1000 milligrams (mg) and should not exceed 2,500 mg in a day for adults. For liquid forms, doses range between 5 and 8.5 milliliters (ml) for adults, and should not exceed 25 ml a day. Children taking liquid forms typically use 5 ml twice a day.
The use of metformin by non-diabetics stems from some evidence that metformin can decrease inflammation, protect against cardiovascular disease and cognitive impairment, minimize cancer risk and progression, and prolong life.
Why is metformin called the miracle drug? Metformin has been referred to as a miracle drug due to its relatively low cost, minimal risks, and ability to ward off diabetes and potentially some effects of ageing.
All things considered, in some people with and without diabetes, metformin can cause a modest reduction in weight. Nonetheless, scientists are still studying why the drug has this effect. Many factors — including appetite reduction because of the drug's side effects — are likely in play.
You're not losing weight or you've gained weight
However, if you're eating healthy and exercising regularly in conjunction with taking Metformin, but your weight hasn't budged or you've gained weight, this could be a sign that you may need to increase your dose or seek an alternative.
Should metformin be used for weight loss? The FDA have not approved metformin for weight loss purposes. However, some doctors will prescribe it to people who are overweight or obese and have type 2 diabetes or prediabetes.
Because of the gastrointestinal side effects of metformin, the usual starting dosage is 500 mg taken with the largest meal of the day. If tolerated, the dosage is gradually increased to 500 mg with each meal.
At 8 months, the 1500-mg group showed a mean reduction of 2.5 kg (mean BMI, 36.8–37.9 kg/m2), whereas the 2550-mg group lost a mean of 3.7 kg (mean BMI, 34.5–36.3 kg/m2). The absolute weight lost did not differ between the dose groups (P = 0.35).
How quickly does metformin work for PCOS? Most medical providers start patients on lower doses of metformin to reduce the severity of side effects. Though each person responds differently, it may take 1-2 weeks or longer to work up to an effective dose.
The main side effects associated with metformin treatment are the gastrointestinal symptoms of nausea, diarrhoea, flatulence, bloating, anorexia, metallic taste and abdominal pain. These symptoms occur with variable degrees in patients and in most cases resolve spontaneously.
Metformin dosage for weight loss
Divided doses should be taken with meals, typically twice per day (for example, with breakfast and dinner). The maximum dose is 2550 mg/day.
Metformin works as a treatment for PCOS by enhancing the body's sensitivity to insulin. This decreases the levels of circulating insulin and also produces a positive effect on adipose (fat) tissue. Doctors traditionally recommend metformin as a PCOS treatment for women who have a raised BMI (body mass index).
Current evidence suggests that the weight change associated with metformin is more likely to be due to decreased caloric intake versus increases in energy expenditure. Metformin appears to impact appetite regulation both directly and indirectly due to its gastrointestinal side effects.
The use of metformin by non-diabetics stems from some evidence that metformin can decrease inflammation, protect against cardiovascular disease and cognitive impairment, minimize cancer risk and progression, and prolong life.
If you stop taking metformin abruptly, your health may suffer. You may experience side effects such as higher blood sugars, an increased A1c, and even weight gain. Over time, higher blood sugar levels can lead to diabetes complications, including: Retinopathy and blindness.
Metformin is best taken during or immediately after a meal to reduce stomach pain, nausea and diarrhoea. The dose may vary depending on what your doctor prescribes, but taking metformin tablets at the same time each day will have the best effect.
“If someone isn't following healthy habits, then taking metformin will not result in weight loss,” she says. “It's important to follow a healthy diet low in refined sugars and carbohydrates if [you are] prone to high insulin levels so that maximum benefit from the medication is received.”
The starting dose for adults with PCOS is 500 mg once a day. Your doctor will increase your dose slowly over a few weeks. This allows your body to get used to the medicine and reduces side effects. The usual dose is 1500–1700 mg per day.