What Is Metformin and How Does It Work?
“[Metformin] has been considered a first-line medication in the治疗2型糖尿病, and it mainly acts by lowering the amount of glucose released by the liver,” saysMinisha Sood, MD, a board-certified endocrinologist who’s based in New York City. “It also helps a hormone calledinsulinto work better by helping muscles use glucose in a more efficient manner. When insulin works better — and insulin sensitivity improves — a person’s insulin levels are lower than they would be otherwise.”
There’s no cure for type 2 diabetes, but the right combination of medication and a healthy lifestyle canstabilize blood sugar levels, which, of course, is the end goal of anydiabetes treatment.
As the medication helps your body properly metabolize glucose from the breakdown of food and restores your ability to respond to insulin, you’ll not only feel better but you can potentially avoidcomplications of high blood sugar, such asheart disease, kidney damage,nerve damage(diabeticneuropathy), andeye damage (retinopathy).
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Why Does Metformin Cause Weight Loss?
The relationship between metformin and weight is unclear, but several theories provide possible explanations for weight fluctuations. Reduced hunger is one documented side effect of metformin, according to theMayo Clinic.
For example, metformin may affect hunger cues. In onesmall study, 12 women withobesity and type 2 diabeteswho 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. Participants received a meal test on each third day and rated their hunger level before eating. Researchers found that hunger levels in the metformin group were significantly lower, especially after the participants took the 1,700 mg dose compared with when they were taking the lower metformin dose or placebo.
If you take metformin, it might not appear as if you’re eating less with this drug. But the number of calories you’re currently consuming for breakfast, lunch, and dinner might be lower than your normal food intake. This subtle change in appetite could be responsible for a gradualdecline in weight.
Having a frequentupset stomachor diarrhea, which is another side effect of the drug, can also affect your food intake.“Temporarygastrointestinalupset, typically experienced at the beginning of treatment, from taking metformin may also play a role in weight loss,” says Suzanne Magnotta, RD, CDCES, vice president of clinical services forAchieving Better Controlin Conshohocken, Pennsylvania.
According to astudy published in the April–June 2017 issue of theJournal of Research in Pharmacy Practice, gastrointestinal side effects are a primary complaint from those who receive metformin tablets in their original formulation. The most common symptoms are vomiting, diarrhea, and nausea, which affects about 2 to 63 percent of people on the drug. Discomfort can be so severe that you may not feel like eating much and subsequently consume fewer calories. The extended release forms of metformin have documented fewer side effects instudies.
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Is Long-Term Weight Loss Possible on Metformin?
Even though metformin can help you shed pounds, the amount you lose might be far less than expected. On average, weight loss after one year on the drug is only 6 pounds, according to theDiabetes Carestudy.
So while metformin is often given to people with high insulin levels who have difficulty losing weight, it’s not a miracle weight loss solution, says Dr. Sood. In other words, don’t expect a dramatic change in weight if you overeat and lead a sedentary life. You must follow asensible weight loss planwith healthy eating and physical activity to see any significant change in weight.
“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 andcarbohydratesif [you are] prone to high insulin levels so that maximum benefit from the medication is received.”
Keep in mind that while the number on the scale might drop while taking this medication, this weight loss may be temporary. You could regain pounds once you stop taking the drug and your appetite returns to normal, hence the importance ofsticking with a healthy lifestyle.
If you’re thinking about taking metformin with a weight loss medication, ask your doctor for recommendations. This combination could help you lose and keep off additional pounds, although there’s little to no clinical trial data to support this claim, says Sood.
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Can People Without Diabetes Take Metformin?
What if you don’t have type 2 diabetes? Can you still take metformin for weight loss? This is an excellent question, and the short answer is yes. Sood explains that metformin has been used off-label, or outside its intended purpose, for weight management.
In fact, areview published in December 2018 in theEuropean Journal of Clinical Pharmacologyexamining the efficacy of metformin for weight loss in overweight and obese people without diabetes concluded that the drug could significantly decrease body mass index in both adolescents and adults.
But because this drug is only available by prescription andhasn’t been approved for weight loss by the Federal Drug Administration, your doctor will likely first recommend some of these traditional strategies for weight loss:
If you don’t have type 2 diabetes, your doctor may sign off on this drug if you’re obese and struggling to lose weight. But again, metformin isn’t a substitute forhealthy eatingandregular exercise, which are keys to sustainable weight loss. These habits also encourage weight loss if you have type 2 diabetes but can’t take metformin.
"For those patients with diabetes who can't take metformin, due to chronic kidney disease or other concerns, diet and lifestyle modifications will still be of utmost importance, whether they’re prescribed alternate medication or not. Controllingcarbohydrateintake, increasing physical activity, andmanaging stressis the cornerstone of improving glycemic control,” says Magnotta.
“Make it a point to stand up every hour or so and walk around the room, the yard, or the block. Little bits of physical activity over the day add up, resulting in the burning of more calories as a result,” she says.
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The Bottom Line on Metformin and Weight Loss
All things considered, metformin can cause a modest reduction in weight, most likely due to side effects, like a decreased appetite and an upset stomach. But although effective for weight loss, the drug doesn’t replace traditional dieting methods. So if you’re looking to lose more and keep the weight off longer, you have to get active and eat right.
