Even in studies that indicated weight loss, the results were modest. One of the most extensive studies to date, performed by the Diabetes Prevention Program (DPP), tested metformin in people with prediabetes (those at risk for developing T2D). People randomly assigned metformin lost an average of 4-7 pounds.
All told, the research suggests a potential 5- to 15-pound average weight loss with metformin.
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.
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. One is that the medication can reduce your appetite.
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.
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%.
Research notes that people who take metformin have lower hunger levels. The drug does not suppress the appetite but instead changes the part of the brain that regulates appetite desire. Metformin may lead people to eat less at each meal, which may help them lose weight.
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.
A medical provider can run a few tests to see how metformin is affecting your health: Blood work can check if your glucose, insulin, and HbA1C levels are in range. If they are, the medication is working.
As much as possible, avoid white bread, white rice, white pasta, candy, soda, desserts, and snacks like chips or crackers. Eating foods that can spike your blood sugar will not necessarily make the metformin not work, however, it will increase the burden it has to work against.
Luckily, metformin may start to work within the first week of treatment. In one study of over 700 people, metformin ER lowered blood glucose within the first week of treatment. But it took about 2 months for it to have its full glucose-lowering effect.
Ozempic has generally been shown to help people lose more weight than metformin, but everyone's experience is different, and weight loss is not guaranteed by either drug – nor is either drug FDA-approved for that purpose.
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).
Taking metformin can cause vitamin B12 deficiency if you take it for a long time. This can make you feel very tired, breathless and faint, so your doctor may check the vitamin B12 level in your blood. If your vitamin B12 levels become too low, vitamin B12 supplements will help.
The administration of metformin, as glucophage retard, at bedtime instead of supper time may improve diabetes control by reducing morning hyperglycemia.
Between semaglutide and metformin, once-weekly semaglutide medications provide more significant results in weight reduction than metformin. Wegovy (semaglutide) is also FDA-approved as a weight management solution, while metformin is used only for weight loss as off-label.
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.
Does metformin make you lose weight with PCOS? Metformin is not a weight-loss drug, but because it helps normalize the insulin and glucose response in the body, it may contribute to weight loss.
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).
Daily Metformin for 2 Years, But Most Benefit Seen in First 6 Months.
The injectable medication acts just like this natural hormone to make you feel fuller for longer and reduces your cravings for more food. Enhancing the way your body regulates blood sugar levels and the storage of fat can help patients lose weight.
So, on average, with the recommended starting Ozempic dose of 0.25 mg, a 500 to 1000 calorie reduced diet, and exercise 3 times a week, you can expect to lose 3-5 pounds in the first month of treatment, which works out to about 3% of body weight for most overweight or obese individuals.
However, they have different mechanisms of action. Ozempic slows digestion, stimulates insulin release, and lowers the amount of glucose the liver releases. Metformin decreases how much sugar the intestines absorb, lowers the amount of glucose made in the liver, and improves insulin sensitivity.