Metformin and body weight

Abstract

Most patients with type 2 diabetes are overweight or obese, overweight or obesity increases the risk of developing type 2 diabetes and obesity per se is strongly associated with multiple cardiometabolic risk factors. However, many antidiabetic treatments increase body weight. The oral antidiabetic agent, metformin, has been evaluated in hundreds of clinical studies in diverse patient populations during approximately five decades of clinical use. This review summarizes the effects of metformin on body weight, with special reference to studies of longer duration (X6 months) as both diabetes and obesity are long-term conditions. Approximately half of studies in drug-naive type 2 diabetic patients demonstrated significant weight loss with metformin compared with baseline or comparator drugs, although pooled analyses have suggested no significant effect versus placebo. Similarly, metformin has been shown to induce weight loss in obese nondiabetic populations, although studies of long duration in this population are scarce. Metformin does appear to mitigate the adverse effects of insulin on body weight. The weight-neutral or weight-sparing effects of metformin constitute a therapeutic advantage in diabetes management where other first-line oral antidiabetic treatments often promote clinically significant weight gain.

Horizons in the Pharmacotherapy of Obesity

“…It has been known for many years that metformin causes only a modest reduction in body weight in diabetic patients [36], though it appears to be at least as effective as orlistat at reducing waist circumference [37]. Recently, there have been reports of its effect on body weight in non-diabetic patients, including children [38].…”

Metformin therapy and clinical uses

“…67,68 Efficacy in special populations Weight Metformin is widely recognised to have either little effect on body weight or to facilitate modest weight loss in type 2 diabetes. 69 There is no major effect of obesity status on the antihyperglycaemic effect of metformin but a slightly larger glucose-lowering effect of metformin has been observed as body mass index (BMI) decreases. 70 The magnitude of the reduction in HbA 1C following metformin decreased by 0.08% units for each increase in BMI of 5 kg/m 2 .…”

“…The modest reductions in body weight often observed with metformin 69 are associated with redistribution of fat from visceral depots to subcutaneous depots, which carry lesser cardiovascular (CV) risk. Bars show 95% CI.…”

Myocardial salvaging effects and mechanisms of metformin in experimental diabetes

“…15 Metformin is renowned to facilitate modest weight loss in type II diabetic patients. (16) In present study Metformin (100 mg/kg) showed significantly decrease in body weight as compared with Diabetic-ISP Control. The study by Poonam Tripathi, et al supported present study that Metformin cause weight loss.…”