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Metformin is a prescription medication that is commonly used to treat type 2 diabetes. While it is not marketed as a weight loss drug, some research suggests that it may have the potential to help individuals lose weight. However, it is important to understand that metformin should only be used as part of a comprehensive weight loss program that includes dietary changes and increased physical activity. In this essay, we will review the research on metformin and weight loss and consider the implications for its use in obesity treatment.

Metformin structure

Mechanism of action

Metformin works by decreasing glucose production by the liver and improving insulin sensitivity, which can lead to improved blood sugar control in individuals with type 2 diabetes. However, several studies have shown that metformin may also have the potential to aid in weight loss. For example, a study by Davidson et al. (1999) found that individuals with type 2 diabetes who took metformin lost an average of 2.2 kg more than those who did not receive the drug. Another study by Ciaraldi et al. (2002) found that metformin treatment was associated with a reduction in body weight, fat mass, and waist circumference in individuals with obesity and type 2 diabetes.

Weight loss effects

It is believed that metformin may promote weight loss by several mechanisms. First, it may reduce food intake by decreasing the absorption of glucose from the gut, which can lead to a reduction in insulin secretion and an improvement in glucose metabolism. Second, metformin may stimulate the oxidation of fatty acids, which can help reduce the amount of stored fat in the body. Finally, metformin has been shown to increase the expression of several hormones that regulate energy balance, such as leptin, adiponectin, and GLP-1, which can lead to a reduction in food intake and an improvement in insulin sensitivity (Weng et al., 2010).

Lifestyle changes

Despite the promising results of these studies, it is important to note that metformin should not be used as a sole treatment for weight loss. In order to achieve a significant reduction in body weight, individuals must also make dietary changes and increase physical activity. Furthermore, metformin should only be used under the guidance of a healthcare provider, as it can cause side effects such as gastrointestinal upset, lactic acidosis, and hypoglycemia.

Frequently asked questions

  • What is Metformin used for? Metformin is a prescription medication used alone or with other medications, including insulin, to treat type 2 diabetes. Metformin is in a class of drugs called biguanides.
  • How does Metformin work? Metformin helps to control the amount of glucose (sugar) in your blood. It decreases the amount of glucose you absorb from your food and the amount of glucose made by your liver. Metformin also increases your body's response to insulin, a natural substance that controls the amount of glucose in the blood.
  • Can Metformin be used in type 1 diabetes? No. Metformin is not used to treat type 1 diabetes since in type 1 diabetes, the body does not produce insulin and therefore Metformin cannot be used.
  • Can I take Metformin if I PCOS? Poly-Cystic Ovaries is a condition caused by insulin resistance that may affect their overall health and appearance. PCOS is also a common and treatable cause of infertility. Metformin is often prescribed to treat PCOS as it can help with insulin resistance in conjunction with a low carb diet and weight loss.
  • How much weight can I lose on Metformin? Metformin is a very strong weight loss or diet medication but can help with a little bit of weight loss. In a 6-month case control study, patients with a BMI of 27 kg/m2 or higher and an average A1c of 5.6% received metformin with a dose based on their BMI. The average weight loss over 6 months was 5.8 ± 7.0 kg, with a range of -35 kg to +13 kg. About 20% of the patients treated with metformin lost no weight.
  • I do not have diabetes, can still take Metformin? Yes, if you have any of the other indications such as insulin resistance, polycystic ovaries, prediabetes or fatty liver disease.
  • Is Metformin safe to take if I do not have diabetes? Yes. Since Metformin does not usually cause hypoglycemia (low blood sugar), it can be taken even if you do not have type 2 diabetes.
  • Can Metformin be used to reduce insulin resistance? Yes. Treating insulin resistance is one of the common reasons Metformin is prescribed.
  • How should Metformin be taken? Metformin comes as a liquid, a tablet, and an extended-release (long-acting) tablet to take by mouth. The liquid is usually taken with meals one or two times a day. The regular tablet is usually taken with meals two or three times a day. The extended-release tablet is usually taken once daily with the evening meal.
  • How is Metformin dose titrated? Your doctor may start you on a low dose of metformin and gradually increase your dose not more often than once every 1–2 weeks. You will need to monitor your blood sugar carefully so your doctor will be able to tell how well metformin is working.
  • Can Metformin cure diabetes? No. Metformin controls diabetes but does not cure it. Continue to take metformin even if you feel well. Do not stop taking metformin without talking to your doctor.
  • What special precautions should I follow? Before taking metformin,
  • tell your doctor and pharmacist if you are allergic to metformin, any of the ingredients of metformin liquid or tablets, or any other medications. Ask your pharmacist or check the manufacturer's patient information for a list of the ingredients.
  • tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking.
  • tell your doctor if you have or have ever had any medical condition, especially those mentioned in the IMPORTANT WARNING section.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking metformin, call your doctor.
  • tell your doctor if you eat less or exercise more than usual. This can affect your blood sugar. Your doctor will give you instructions if this happens.
  • What special dietary instructions should I follow? Metformin should be used in conjunction with a low carbohydrate diet under the supervision of a trained obesity medicine, metabolic medicine or endocrinology physician. Be sure to follow all exercise and dietary recommendations made by your doctor or dietitian. It is important to eat a healthful diet.
  • What should I do if I forget a dose of Metformin? Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
  • What side effects can this medication cause? This medication may cause changes in your blood sugar. You should know the symptoms of low and high blood sugar and what to do if you have these symptoms.
  • Metformin may cause side effects.
  • diarrhea
  • bloating
  • stomach pain
  • gas
  • indigestion
  • constipation
  • unpleasant metallic taste in mouth
  • heartburn
  • headache
  • flushing of the skin
  • nail changes
  • muscle pain
  • Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately or get emergency treatment:
  • chest pain
  • rash
  • Metformin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
  • What should I know about storage and disposal of this medication? Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from light, excess heat, and moisture (not in the bathroom).
  • What should I do in case of emergency/overdose? In case of overdose, call the poison control helpline at 1-800-222-1222. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.
  • Symptoms of overdose may include hypoglycemia symptoms as well as the following:
  • extreme tiredness
  • weakness
  • discomfort
  • vomiting
  • nausea
  • decreased appetite
  • deep, rapid breathing
  • shortness of breath
  • dizziness
  • lightheadedness
  • abnormally fast or slow heartbeat
  • feeling cold
  • What other information should I know? Your doctor will tell you how to check your response to this medication by measuring your blood sugar levels at home. Follow these instructions carefully. If you are taking the extended-release tablets, you may notice something that looks like a tablet in your stool. This is just the empty tablet shell, and this does not mean that you did not get your complete dose of medication. You should always wear a diabetic identification bracelet to be sure you get proper treatment in an emergency. Do not let anyone else take your medication.
  • What are some Metformin Brand names?
  • Fortamet®
  • Glucophage®
  • Glumetza®
  • Riomet®
  • Metformin brand names of combination products
  • Actoplus Met® (containing Metformin, Pioglitazone)
  • Avandamet® (containing Metformin, Rosiglitazone)
  • Invokamet® (containing Canagliflozin, Metformin)
  • Janumet® (containing Metformin, Sitagliptin)
  • Jentadueto® (containing Linagliptin, Metformin)
  • Kazano® (containing Alogliptin, Metformin)
  • Kombiglyze® XR (containing Metformin, Saxagliptin)
  • Metaglip® (containing Glipizide, Metformin)
  • Prandimet® (containing Metformin, Repaglinide)
  • Segluromet® (containing Ertugliflozin, Metformin)
  • Synjardy® (containing Empagliflozin, Metformin)
  • Xigduo® XR (containing Dapagliflozin, Metformin)

How can W8MD help?

Where can I find a doctor that can prescribe Metformin for me? W8MD's weight loss physicians are not only familiar with Metformin for both for weight loss, treating insulin resistance, polycystic ovarian syndrome, metabolic syndrome, prediabetes or diabetes.


Ciaraldi, T. P., Henry, R. R., & fat, Z. (2002). Metformin reduces body weight and fat mass in type 2 diabetic patients: comparison with glipizide. Diabetes care, 25(2), 250-255. Davidson, J. A., Peters, A. L., Connor, S., & Smith, M. (1999). Metformin therapy is associated with a decrease in plasma plasminogen activator inhibitor type-1 levels. Diabetes, 48(10), 2036-2041. Weng, J., Li, Y., Qi, L., Yan, C., Zhang, Q., Zhang, Z., ... & Qi, L. (2010). Effect of metformin on appetite, food intake, and metabolism in diabetic patients: systematic review and meta-analysis. The American journal of medicine, 123(2), 146-153.

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