When it comes to how much metformin for weight loss, the dosing approach is usually gradual to minimize side effects. Unlike stimulant-based weight loss medications or GLP-1 receptor agonists like semaglutide, the changes with metformin happen slowly and often subtly. In people with insulin resistance or PCOS, the weight loss may be slightly more pronounced—some studies show an average reduction of up to 9 pounds over the course of a year. Metformin was well tolerated; gastrointestinal effects were the most frequently reported adverse effects. Dangerous side effects are very rare, but can include lactic acidosis, allergic reaction, or hypoglycemia. GLP-1 medications currently available to Calibrate members include Wegovy®, Mounjaro™, Ozempic®, Rybelsus®, Saxenda®, and Trulicity®. Your care plan may vary based on other medications you are taking or preexisting conditions. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Is metformin a wonder drug? The effective dose used in the studies ranged from 1,000 mg per day to 2,550 mg per day. The study durations ranged from around six months to four years, so this is a modest reduction in weight over that time period. Patients lost an average of 4.92 pounds more on metformin than on placebo pills. The drug metformin is known to activate AMPK thus, partially could have a protective role in Alzheimer’s disease and others oxidative distress related neurological disorders. Activation of AMPK pathway play a vital role in reducing insulin resistance and oxidative stress. The brain cells here are dependent on glucose for survival and have low antioxidant enzyme contents as a result of oxidative injuries. Second, in vitro studies revealed that the concentration of metformin required for activation of AMPK is greater than that for acute inhibition of gluconeogenesis in hepatocytes . Berberine improves insulin sensitivity by upregulating autophagic levels in macrophage and inhibiting ATM phenotypic switch to decrease CD11c+ population 94, 95. In light of the anti-tumour activities mentioned above, simultaneous treatment of inflammation and cancer by berberine or metformin may yield a better prognosis and point to a new research area . Nowadays, it is accepted that dysregulation of immunity is involved in diabetes, obesity, cardiovascular diseases and cancer. In terms of possible role in inhibiting EMT and metastasis of cancer, berberine and metformin seem to have similar effects 81–83. Reduction in LDL cholesterol has been demonstrated to reduce cardiovascular risk and mortality in a continuous and graded manner over a wide range of LDL cholesterol levels. In clinical practice, LDL cholesterol has replaced total cholesterol as a risk marker and the primary treatment target for hyperlipidemias . Moreover, to our knowledge, ours is the first meta-analysis, in which elderly patients were in the primary focus. With regard to the adverse effects of metformin, mild gastrointestinal adverse effects/digestive tracts symptoms (e.g. diarrhea, flatulence) appeared more commonly in the metformin group as indicated in four of the six articles 23–25, 28. Using metformin for weight loss in non-diabetics should always be done under medical supervision. By promoting a healthier balance of gut bacteria, metformin may aid in weight management. By modulating appetite, metformin can help reduce caloric intake, contributing to weight loss. Improved insulin sensitivity helps lower circulating insulin levels, reducing the tendency for the body to store fat. This mechanism also indirectly influences weight by reducing insulin levels, which can promote fat storage. Remember, the goal is to find metformin dosing for weight loss that effectively aids in reducing body mass while minimizing potential side effects.Metformin may contribute to overall weight loss, which can include reductions in belly fat.We aimed to investigate the long-term effect of metformin on the blood glucose control in non-obese patients with type 2 diabetes mellitus.Yes, non-diabetic individuals can use Metformin off-label for weight loss, but it is essential to consult with a healthcare provider before starting the medication.Like the GLP-1 enzyme, GLP-1 receptor agonists can suppress appetite, delay gastric emptying, reduce plasma glucose levels, and enhance insulin secretion, thereby controlling glucose levels in the body .But is metformin actually shown in research studies to cause weight loss?Accumulated clinical trials have evaluated that metformin had benefits on different cancers.Three studies showed a significant improvement in insulin sensitivity in the metformin versus the control group.Metformin naïve, type 2 diabetic patients, who completed a single exercise bout after 4 weeks of 2000 mg of metformin daily, had a greater glycemic response to a mixed meal when compared to the same trial without metformin.16 Comparable effect was observed by Myette-Côté et al17 who failed to observe the improvements in glucose-lowering effects of exercise when an acute bout of aerobic training was added to metformin-treated T2DM patients. Therefore, it is often best used as part of a comprehensive weight management plan that includes a balanced diet and regular physical activity. In rare cases, Metformin can lead to more serious complications, such as lactic acidosis, a potentially life-threatening condition characterized by the buildup of lactic acid in the bloodstream. These symptoms often occur when first starting the medication and can usually be mitigated by gradually increasing the dosage or taking the medication with food. A randomized, double-blind, placebo-controlled trial of adjunctive metformin therapy in overweight/obese youth with type 1 diabetes. In the present study, the Emax of metformin on BMI in patients with obesity, patients with type 1 diabetes mellitus, patients with nonalcoholic fatty liver, and patients with precocity were -10, -4.31, -4.7, and -9.41, respectively. A total of 18 RCT studies, 1,228 children and adolescents, were included for analysis, including patients with obesity, patients with type 1 diabetes mellitus, patients with nonalcoholic fatty liver, and patients with precocity. The purpose of this study was to analyze the time course and dose effect from metformin on body mass index (BMI) in children and adolescents by model-based meta-analysis (MBMA). Early work in isolated lysosomes also suggests that metformin may act to coordinate AMPK activation and mTORC1 inhibition via direct effects . More work is needed to determine how the disparate effects of metformin are mediated by common versus distinct effector mechanisms. Elegans, AMPK is genetically required for the prolongevity effects of metformin, an effect that has been reproduced by multiple research groups 21, 22, 25. The inhibition of mGPDH by metformin decreases the cytoplasmic NAD/NADH ratio and reduces hepatic glucose production in mice. From a longevity standpoint, metformin effects on mTORC1 and longevity are in line with the well-known ability of genetic and pharmacologic inhibition of mTORC1 to extend lifespan across multiple model systems 51–57. In meta-analyses, weight gain with insulin analog therapy was found to positively correlate with insulin dosage and to be greater with biphasic (premixed) insulin than with basal insulin alone 48, 76, 78. Compared with most other antihyperglycemia therapies, there is a substantial risk of hypoglycemia with insulin—especially with regimens that include prandial insulin . A significant proportion of patients with T2D require insulin therapy as their disease progresses because of β-cell failure. Insulin remains the most effective glucose-lowering agent—especially in patients with elevated A1C. There are several reasons why metformin is not more widely prescribed for weight loss. Metformin appears to be most effective in promoting weight loss in individuals with a higher baseline body mass index (BMI). Overall, the magnitude of weight loss induced by metformin appears to be modest, typically ranging between 1-3 kg in both diabetic and non-diabetic populations. Pearson similarity testing, and Venn diagram presentations to develop Metformine, and diabetes related metabolic patterns were performed using Multiple Professional Profiler (MPP) software (Agilent In, CA). This type of analysis seemed best to reduce the probability of making a type 1 error since it supports the testing of pairwise differences due to the unequal group sizes among the experimental and the control groups, as seen in our cohorts. For statistical analysis among the groups, analysis of variance (ANOVA) using post-hoc Tukey’s analysis method, with multiplicity-adjusted p-values, for each comparison was used. Multivariate analysis (partial least square-discriminant analysis (PLS-DA)) was carried out to identify any clustering or separation between the compared data sets. A univariate analysis using a volcano plot was performed for each binary comparison to identify significantly differentially expressed metabolites based on a fold-change criterion of greater than 1.5 or less than 0.67 with a false discovery rate (FDR) adjusted p-value less than 0.05. Significant differences between the mean age of the placebo and metformin groups before randomization were indicated in two of the articles.Get the latest in health news delivered to your inbox!Moreover, in contrast to other antidiabetic treatments, metformin seems to be weight neutral or can even help to decrease body weight by decreasing food intake 4,5.Compared with baseline, weight decreased by 7.3% in the lifestyle plus metformin group, by 4.9% in the metformin-only group, and by 2.2% in the lifestyle-only group; in the placebo group, weight increased by 4.8%.Despite its pleiotropic properties, the precise mechanisms behind metformin mode of action, especially in obese diabetic patients, are still elusive, and various metabolic pathways may be involved.Fewer than 10 cases of metformin hepatotoxicity have been reported, which may be explained by the concomitant intake of other potentially hepatotoxic drugs (95).The primary outcome measure of efficacy was mean change in weight in kg between pre-treatment and end of study weight.Metformin participants reported more gastrointestinal symptoms than placebo participants, however these abated over time and both types of gastrointestinal symptom reports were similar between groups by the latter years of the DPPOS. Common Side Effects Metformin is a medication primarily used to manage type 2 diabetes by controlling blood sugar levels. I plan to continue using metformin as part of my diabetes management, but I've realized that weight loss requires a more comprehensive approach, including diet and exercise modifications. While it's not a magic solution, metformin has been an effective tool for managing my weight and blood sugar levels. I started taking metformin as part of my type 2 diabetes treatment, but to my surprise, it also had a positive impact on my weight. The medication's weight loss effects are generally gradual and can vary among individuals. Metformin is widely recognized as a safe medication for most individuals, especially when used under the guidance of a healthcare professional. The dosage and treatment plan should be closely monitored by a healthcare professional. The exact dosage should be determined by a healthcare provider based on individual health needs and response to the medication. The optimal dosage of Metformin for weight loss varies, but it typically ranges from 500 mg to 2000 mg daily. Metformin is a widely used prescription medication that has been FDA (U.S. Food and Drug Administration) approved to treat type 2 diabetes. Additionally, it’s crucial to be aware that metformin overdose can lead to hypoglycemia and lactic acidosis, necessitating immediate discontinuation of the medication and supportive care. In 2025, this medication continues to be a cornerstone in managing blood sugar levels, with usage statistics reflecting its ongoing importance. Recent research suggests that this medication can lead to weight reduction in individuals with type 2 conditions, with some experiencing decreases of up to 5-10% of their body weight. This medication is a commonly utilized oral antihyperglycemic agent primarily prescribed for managing type 2 diabetes, as indicated in the metformin dosage chart. They not only optimize outcomes but also minimize side effects, empowering individuals with type 2 diabetes to approach their health journeys with confidence and support. Our findings are similar to Cabioglu’s findings30 that show a decrease in blood glucose levels in obese women, who are treated by EA in combination with a calorically restricted diet. A study by Liao et al.17 has reported a glucose-lowering effect of EA+metformin through activation of GLUT4 and upregulation of MAPK expression in insulin-resistant rats. Although there is a correlation in healthy individuals between BMI and CRP levels, CRP is known to be an independent parameter.15 Abdi et al.26 assessed the role of acupuncture on CRP levels during weight loss, in which CRP did not significantly change between two groups; our findings were consistent with these data and did not show changes in CPR levels. Secondly, the meta-analysis assessing the efficacy of metformin interventions in preventing T2DM yielded a significant reduction in the risk of developing the disease. This study aims to provide a comprehensive synthesis of the available evidence on the effectiveness of metformin in diabetes prevention. For decades we've known that metformin does more than just help lower blood sugar in people with diabetes. It has since become the most widely prescribed medication for people with diabetes who cannot control their blood sugar through diet and exercise alone. Amino acids and their metabolites are an important regulator of insulin secretion and sensitivity (Newgard, 2012).After randomization, participants began treatment with one 500-mg metformin capsule or matching placebo twice daily, to be taken with morning and evening meals for the first week.This drug can be used as a complementary therapeutic agent for cancer treatment.The findings of the study indicated that both lifestyle intervention and metformin significantly reduced the development of diabetes over 15 years.Metformin has a positive effect on the endothelium and adipose tissue independent of its action on insulin and glucose levels Diamanti-Kandarakis et al. 2010.We studied the effects of metformin in obese children aged 6–12 years who were believed to be at particular risk because they manifested a significant degree of insulin resistance.Early work in isolated lysosomes also suggests that metformin may act to coordinate AMPK activation and mTORC1 inhibition via direct effects .As research continues to evolve, the evidence supporting the medication’s effectiveness in weight management and its positive impact on cardiovascular health remains strong, solidifying its status as a vital component of comprehensive diabetes care. In order to use of metformin for weight loss should be discussed with a healthcare professional who can provide personalised guidance based on individual health needs and considerations. Typically, for adults without diabetes seeking weight loss, a typical starting dose of Metformin is 500 mg to 850 mg once or twice daily with meals. For mild to moderate insulin resistance or diabetes, starting with a lower dose and gradually increasing it over time may be recommended to minimise side effects like gastrointestinal upset. Metformin weight loss primarily by improving insulin sensitivity and reducing glucose production in the liver. Lactic acidosis is rare but life threatening condition when, there is too much of lactic acid build up in the bloodstream. If you have been affected with diabetes, you should have a test of HbA1c once in three months. It should be avoided in patients suffering from moderate to severe kidney disease and in patients with underlying metabolic acidosis including diabetic ketoacidosis. Acmeglim-Mv 2/0.3 Tab should be avoided in patients who are allergic to any of the components or excipients of this medicine. This evidence-based review from the Cleveland Clinic Journal of Medicine examines metformin’s off-label use for weight management in patients with obesity but without diabetes. Whether you take metformin for weight loss or to treat diabetes, the medications are the same. In a long-term study involving over 3,000 people, the average weight loss for participants who took metformin was 5.5 pounds. Before metformin treatment was started insulin sensitivity was determined in all patients by calculating HOMA index and Matsuda index after a 75 g oral glucose tolerance test. Hi, I’m Barbara Yarnell – the voice behind this blog and your guide on the journey to healthy weight loss. The FDA-approved GLP-1 RA/GIP co-agonist, tirzepatide, effectively lowers glucose and promotes weight loss, achieving mean reductions of 13. Clinicians now must guide type 2 diabetes patients on incorporating SGLT2 inhibitors, GLP-1 receptor agonists, finerenone, or tirzepatide into their treatment. Evidence from a retrospective cohort study indicated that dapagliflozin may pose a lower heart failure risk compared to empagliflozin in diabetic patients. Understanding the relationship between Metformin and weight is important for anyone considering the medication. This article will answer the most common questions people have when they search online about Metformin and weight loss. Some studies suggest that Metformin may help people with PCOS lose weight, although results are not always consistent. Metformin long term usage studies- both for safety and effectiveness have been very positive. The fact that it costs only $6 a month and has little to no side effects makes ideal for long term use. It has been used for more than 40 years for the treatment of Polycystic ovary syndrome and type 2 Diabetes. With the progression of the pathophysiology of T2DM, specifically with decreased insulin sensitivity, multiple symptoms such as hormone alterations, mitochondrial dysfunction, and altered fat oxidation arise.29 Decreased insulin-mediated suppression of hormone-sensitive lipase in IR leads to increased hydrolysis of triglycerides, and elevated blood free fatty acids (FFA) levels promoting dyslipidemia, and CVD development.5,29,31,32 This increase in FFA circulation is not only a concern when it comes to the proliferation of CVD disease, but it seems to have a significant effect on insulin sensitivity.Recent statistics indicate a growing preference for ER formulations among individuals, as they generally experience fewer gastrointestinal side effects compared to IR options.However, it is essential to remember that metformin is not a quick fix and should be used in conjunction with a healthy diet and regular exercise.Ultimately, effective management of Metformin relies on a proactive and collaborative relationship between you and your healthcare provider.The present study has revealed significant changes in different metabolites; some were specific for metformin and T2DM regardless of obesity.This can help reduce cravings for sweets and other unhealthy foods that may be contributing to your weight problems.Overall, the interplay of these enzymes is vital for maintaining optimal digestive health. Women who suffer from PCOS are at increased risk of pregnancy-induced hypertension (PIH) and pre-eclampsia (PE) compared with non-PCOS pregnant women Boomsma et al. 2006. This question is of importance for the PCOS women who are seen for the first time during pregnancy; should they be given metformin or not? Glueck and colleagues reported a prevalence of GDM of 7% among pregnant PCOS women who continued taking metformin throughout pregnancy compared with 30% among those who did not. This subsequently led to a wide discussion on whether the continuation of metformin in pregnancy is of benefit to women with PCOS Norman et al. 2004. Further, it has been reported that the risk of PCOS is significantly high at 40% among women with a previous history of GDM. The average dose ended up being 2,230 milligrams per day. In one study, people started by taking 500 milligrams daily and gradually increased to 2,500 milligrams. Make sure your doctor knows about all the medications you take. But experts now believe some people with these conditions can take metformin, as long as they're watched carefully to avoid complications. Previously, doctors didn't prescribe metformin to people with congestive heart disease or chronic liver disease. Participants also showed improved glucose control over the follow-up period 23, 24. Nutrition education at diagnosis and throughout the care process is advocated by the ADA and the AACE/ACE to support lifestyle modification and achieve weight-loss 8, 13, 17, and is an annually renewable benefit in insurance plans in the US 18, 19. Recommendations for bariatric surgery differ between guidelines, with AACE recommending it as an option for patients with a BMI ≥ 35 kg/m2, and ADA recommending it for patients with a BMI ≥ 40 kg/m2 (≥ 37.5 kg/m2 in Asian Americans) 8, 13. Using data from a large integrated healthcare system, we sought to describe the percent change in body weight from baseline among patients with overweight or obesity and type 2 diabetes 72 weeks after starting a GLP-1 agonist.Adverse events reported with a frequency greater than 10% in the mazindol-metformin and mazindol groups, respectively, were nausea (22 vs. 10%), constipation (15 vs. 13%), dry mouth (10 vs. 16%), and headache (11 vs. 24%); diarrhea was less common (5 vs. 4%).In the last decade, many reports have highlighted the possibility of metformin affecting the thyroid-stimulating hormone (TSH) and concluded that it has no effect on thyroid hormone (T3 and T4) 25, 26.However, the extent of weight loss varies among individuals, and not everyone may experience significant changes.We designed this randomized clinical trial (RCT) to compare the therapeutic effects of Metformin monotherapy with Metformin and acupuncture combined therapy on weight loss and insulin sensitivity.These drugs help the body lower blood glucose levels by blocking the breakdown of starches, such as bread, potatoes, and pasta in the intestine.This section explains how diet and physical activity work together with Metformin to help with weight loss and overall health.A total of 6,823 participants completed the run-in and had reported metformin doses and HbA1c measurements at screening and at a final run-in visit.This work represents the first guideline solely dedicated to the use of metformin to manage AIWG, and builds on both the quality and number of recommendations available. First, metformin increases the body’s response to leptin–a hormone released from your body’s adipose tissue to send signals of satiety or fullness to the brain after meals–which can help curb your appetite and prevent overeating. The medication also works for other diabetic conditions, such as gestational diabetes, a form of diabetes that sometimes develops in expecting mothers between the 24th to 28th week of pregnancy. Many adults that take metformin for diabetes commonly report experiencing issues such as stomach aches and diarrhea. At this time, the use of metformin is not recommended as treatment of these conditions. It’s a good idea to have your B12 levels checked periodically, especially if you begin experiencing symptoms like fatigue, tingling in the hands or feet, or brain fog. A less common side effect is vitamin B12 deficiency, which may develop with long-term use of metformin. While metformin is generally considered safe and has a long history of use, it’s not without potential downsides. Many women find that metformin improves their cycle regularity and increases the likelihood of ovulation—both of which can support fertility. For many women with PCOS, weight gain is both a symptom and a complicating factor. Baseline demographic and clinical variables were measured during the 52 weeks prior to the first GLP1-a dispense date and extracted from the electronic health record portion of the dataset. When there was more than one weight measurement in a given 8-week interval, we randomly selected a weight measurement for that window. Data sharing not applicable as no datasets generated and/or analysed for this study. We are sincerely grateful to all members of the guideline development group and external reviewers who are not listed as authors, but who without their help, this body of work could not have achieved the quality that it has. This work represents the first guideline solely dedicated to the use of metformin to manage AIWG, and builds on both the quality and number of recommendations available. Rarely, lactic acidosis can occur, mainly in diabetic patients, which is a serious condition that can potentially be fatal. Metformin inhibits hepatic gluconeogenesis and it also increases the glucose uptake by peripheral tissues and reduces fatty acid oxidation Kirpichnikov et al. 2002. Further, clinical quantification of IR is not accurate enough Legro et al. 2004; Gennarelli et al. 2000 to enable a better understanding of the role of IR in PCOS pathogenesis or to incorporate it into the work up programme of PCOS patients. An estimated prevalence of IR among PCOS patients of 60–70% has been reported DeUgarte et al. 2005. However, it is recognized by many as a common feature in PCOS independent of obesity Dunaif et al. 1987; Chang et al. 1983; Burghen et al. 1980. A significant FPI reduction was observed in mazindol-metformin, but not in the mazindol group at months 3 and 6. Mazindol and mazindol-metformin induced slight but significant FPG reductions, which were more pronounced at the 3rd month compared with the 6th month. A greater but non-statistically different proportion of subjects in the mazindol-metformin achieved a ˃ 7% BW reduction compared with the mazindol-only group at months 3 (68.1 vs. 52.3%) and 6 (77.8 vs. 69.2%). Treatment with mazindol alone or in combination with metformin significantly reduced mean baseline BW by months 3 (–6.4 and –7.3 kg, respectively) and 6 (–8.6 and –9.9 kg, respectively). Table 3 shows the mean changes in variables under investigation for subjects in the mazindol-only and mazindol-metformin groups. Patients were followed up at weeks 4, 8, 12, and 16 for anthropometric measurements and interviewed for side effects. Tables 1, 2 summarize the study and population characteristics, respectively. Out of seven, one was an extension of the included study, and two were abstracts of included study. The statistical level of significance for the summary treatment effect estimate was analyzed in a random effect model by inverse variance and Mantel- Haenszel method (33). The presence of heterogeneity among these studies was evaluated with the Cochrane Q χ2 test. The ET50 of metformin on BMI in patients with obesity, patients with type 1 diabetes mellitus, patients with nonalcoholic fatty liver, and patients with precocity were 15.2, 25.2, 6.57, and 12.4 weeks, respectively.The purpose of this manuscript is to review the mechanisms that underlie metformin's effects on obesity.In U.S. clinical trials, about 4% of participants were unable to continue metformin due to adverse effects.Several studies have reported the benefits of metformin in CVDs and heart failure in patients with or without diabetes, and it will be interesting to explore more possible applications of metformin in the future.The results of this study show improvement in all measured parameters in both the case and control groups, but the changes were significant only in the case group, in which participants were treated with true acupuncture.Investigating the T2DM metabolic pattern in obesity revealed that 30 and 41 metabolites were up- and down-regulated, respectively, in T2DM.Many women with PCOS experience weight gain or difficulty losing weight due to hormonal imbalances and insulin resistance.The change rate of weight from baseline was selected as the efficacy indicator. A possible mechanism of this inverse correlation may be related to the inhibition of NF-κB in the vascular wall by metformin . LDL-C level is an important risk factor for atherosclerosis and every 38.7 mg/dL reduction of LDL-C results in a 20% reduction in cardiovascular events . Therefore, metformin may play an anti-atherosclerotic role through AMPK-mediated VSMCs regulation. Metformin, being an agonist of AMPKα2, can activate AMP-activated protein kinase and protect human coronary artery endothelial cells against diabetic lipoapoptosis , suggesting an alternative mechanism of cardioprotective effect in the body. Further studies have shown that it may increase NO production by activating AMPK pathway and thus improve vascular endothelial function . Four of the studies received maximal score, and no study was considered low quality. Significant differences between the mean age of the placebo and metformin groups before randomization were indicated in two of the articles. With regard to the presence of small study effect, due to the low number of the included studies, the results of the Egger’s test are not informative; therefore they were omitted from the results. The differences were calculated by subtracting paired change after metformin from paired change after placebo. A medication, many effects: The paradigm shift Furthermore, any adverse effects that may have manifested were monitored and recorded. Metformin has been approved for the treatment of AIWG, with established guidelines for its use . Prior research has demonstrated the feasibility, effectiveness and safety of metformin as a pharmacological intervention for AIWG . Pharmacotherapy represents a relatively new approach to the management of AIWG and obesity . Despite these precautions, a considerable number of patients will still develop AIWG and require appropriate interventions. Several effects have been reported as related to metformin in PCOS patients including restoring ovulation, reducing weight, reducing circulating androgen levels, reducing the risk of miscarriage and reducing the risk of gestational diabetes mellitus (GDM). Today, we’ll discuss how metformin can lower blood sugar levels, the mechanisms of action it utilizes to stimulate weight loss, and how those effects on the body can also help non-diabetics lose weight. A meta-analysis by Jia et al. (2021) found that metformin treatment resulted in a mean weight loss of 2.54 kg in obese individuals without diabetes. While weight loss is not the primary intended effect of metformin, studies have shown that it can lead to modest reductions in body weight, particularly in individuals with obesity and insulin resistance. Since the medication can stimulate weight loss in people with Type 2 diabetes, many physicians commonly prescribe the medication as an off-label weight loss treatment for obese patients who are non-diabetic. Among these metabolites, 114 were up-regulated, and 108 were down-regulated in LT2DMMet compared to the healthy lean group (Figure 5B). Among these metabolites, 61 were up-regulated, and 48 were down-regulated in OT2DMMet compared to the obese group (Figure 5A). These 132 metabolites showed a persistent metabolic pattern as an effect of both T2DM and metformin administration. Taking a proactive approach to discussing your treatment plans and any side effects with your healthcare providers can lead to more personalized and effective management strategies. Moreover, the unique ability of this medication to enhance insulin sensitivity has sparked interest in its broader therapeutic applications, including potential benefits for obesity and metabolic syndrome. At Minimal, we understand the importance of personalized weight loss strategies and holistic health approaches. Furthermore, the average number of low risk of bias evaluations in studies concerning the medication was reported as 4.42 ± 1.42, indicating a dependable basis for the information presented. In practical situations, numerous individuals have effectively handled gastrointestinal side effects by modifying their medication schedule according to the metformin dosage chart, showcasing the importance of customized care plans. Is Metformin safe for non-diabetics to use for weight loss? The usual dosage of Metformin was on the higher side with most of the patients taking 2230 mg/day. Many of these metabolic changes are the underlying problems in type 2 diabetes and polycystic ovary syndrome. Metformin Actions to Produce Weight Loss in Non-Diabetic Obese and Overweight Individuals Body weight A recent meta-analysis including the latest generation of insulin analogs showed that treatment with insulin glargine 300 U/ml resulted in a comparable change in body weight to treatment with insulin detemir, NPH insulin, or insulin degludec, but significantly lower weight gain when compared with premixed insulin .But, it should not take the place of healthy and proper dieting and exercise.AMPK is an energy-sensing enzyme that plays a key role in nutrient regulation and insulin sensitivity.41 As a result of the multifaceted effect that this kinase has on metabolism (Figure 1), it has been actively studied in the context of metabolic disorders including IR.Fortunately, Metformin is one of the cheapest and most effective drugs used by people worldwide to treat diabetes.While it is primarily prescribed for diabetic patients, studies have shown that it may also aid in weight loss for those without diabetes.O'Brien et al. conducted a study to compare the effectiveness of intensive lifestyle intervention and metformin in individuals participating in the DPP, considering their level of education .Both hemoglobin and hematocrit declined slightly in the metformin group over the first year after randomization and stabilized after that.Metformin is a biguanide, and it works by increasing the amount of glucose that your liver and muscles can use for energy.The addition of metformin to insulin therapy in an attempt to improve insulin sensitivity, support weight control, and reduce insulin dose requirements in patients with T1DM has been assessed in some studies and systematic reviews (66). The aim of this review was to assess the effect of metformin on non-diabetes related medical diseases. Through more than six decades of metformin use, it became the most studied hypoglycemic agent; through these studies, it showed a marvelous non-glycemic related effect. A 4-week single-blind placebo lead-in period preceded and a 6-week single-blind placebo period followed the 24-week double-blind treatment period. The 1700-mg metformin dose had the most marked appetite suppressant action. People who take Metformin and expect dramatic weight loss may be disappointed. The truth is that while Metformin can help some people lose weight, its primary function is to manage blood sugar. Exercise also helps improve insulin sensitivity, making Metformin work more effectively in the body. One important point is that Metformin alone does not cause significant weight loss for most people. The weight loss seen with Metformin is usually slow and moderate, often ranging from 2 to 10 pounds over several months. Among these metabolites, 2 (out of 5) and 8 (out of 12) metabolites were up- and down-regulated as an effect of metformin in obese diabetic patients (Figure 4D). As shown in Figure 4A, 17 metabolites were statistically significant due to metformin administration in obese diabetic patients. The effect of metformin administration on metabolites in obese diabetic patients was investigated based on comparing OT2DM vs. OT2DMMet groups from the obese cohort. These dysregulated metabolites' identity as an effect of T2DM in obesity and their levels in different study groups are shown in Figures 2G,H. A total of 107 metabolites (identified and unidentified) were significantly dysregulated of which 78 were up-regulated, and 29 were downregulated in obese diabetic patients on metformin as shown in metformin panel, volcano plot, Figure 1D. The type of tablet prescribed to you determines how often the medication is taken. Recommended metformin dosages can range from 500 to 2,550 milligrams (mg). Be sure to speak with a healthcare provider about the proper dosage for you. Metformin is an oral medication that should be taken with food. The dosage of metformin used in clinical studies for weight loss depends on the age of the patient. A recent clinical trial found metformin to be effective for weight loss even in non-diabetic patients. A 2018 meta-study concluded that metformin was effective for weight loss. In this article we'll answer all of these questions and more, as we analyze research studies on metformin to determine if the drug actually causes weight loss, and if so, how much. But is metformin actually shown in research studies to cause weight loss? Personalized dosing helps maximize the benefits while minimizing side effects, no matter your goal. When taking metformin, consistency and timing matter. The choice between IR and ER metformin depends on your tolerance, lifestyle, and medical history. Metformin is taken in pill form, usually once or twice a day, and people start on a low dose that’s gradually increased. Improve your health and see it in your biomarkers. No formal statistical procedures or tests were performed because there was not sufficient similar information from each article to achieve a meaningful meta-analysis. All outcomes were assessed at the maximum follow-up time or the end of treatment. Authors of studies with the potential to meet inclusion or exclusion criteria by additional unpublished information were contacted. Funnel plot with standard error on the vertical axis and treatment effect on the horizontal axis is given in Fig. One study of 16 weeks duration gave data only for the week 8 value . The forest plot from the meta analysis of change in FBS is given in Fig. The forest plot from the meta analysis of change in BMI is given in Fig. The association of diabetes with risperidone and quetiapine is uncertain, and early experience with aripiprazole and ziprasidone does not indicate an increased risk of diabetes.3,4 Olanzapine and clozapine definitely increase the risk for diabetes. This is useful information, because most second-generation (or atypical) antipsychotic medications cause weight gain. This study gives us an additional tool for treating antipsychotic-induced weight gain. Concerned because his mother has diabetes, he asks if you can help him lose weight safely. The combination of metformin and lifestyle intervention shows synergistic effects, emphasizing the importance of comprehensive approaches in diabetes prevention strategies. This systematic review and meta-analysis provides strong evidence supporting the effectiveness of metformin in the prevention of diabetes mellitus. Furthermore, a study by Rena et al. explored the mechanisms of action of metformin and its role in preventing diabetes . In addition, HbA1c and blood pressure remained mostly unchanged in both treatment groups. Both treatments led to similar reductions in FPG and TGL, but only mazindol-metformin was related to sustained reductions in FPI and HOMA-IR. 137 subjects completed the study and met at least 80% treatment compliance. With respect to biochemical determinations, both mazindol and mazindol-metformin produced similar sustained reductions in TGL (approximately –25 to –30 mg/dL) at months 3 and 6, which were statistically significantly different from their baseline values, but not between treatment groups. For example, β-cells compensate for IR by increasing insulin secretion, and as insulin increases, IR becomes more dramatic. Our results show that acupuncture and Metformin combined therapy is able to significantly reduce levels of FINS. We also measured other parameters that can be influenced by obesity, such as FBS, FINS and HOMA. In similar, our results support our hypothesis in that acupuncture and Metformin combined therapy is more effective than Metformin monotherapy, in inhibiting inflammation, which in turn may improve insulin sensitivity. Therefore, we conclude that acupuncture treats obesity at least partially, by enhancing the anti-inflammatory mechanism. The initial dose is usually 500mg once daily, with gradual increases based on tolerance. Herein, we discuss the potential mechanisms by which metformin decreases appetite and opposes unfavorable fat storage in peripheral tissues. We process personal information and consumer health data to provide you with our products and services and maintain essential website functionality. Poor association are shown between use of metformin and lung cancer . The cell lines which are responsive to metformin stimulate AMPK via LKB1 and prevents mTOR. Cell lines were either responsive to metformin or remained non-responsive to metformin. This mechanism of action promotes healthy insulin sensitivity, which helps the body use smaller amounts of insulin more effectively, resulting in lower blood sugar levels. Metformin is an anti-diabetic medication that is usually prescribed along with exercise and diet regimens to help maintain the blood sugar levels in patients with type 2 diabetes. However, before you ask your physician about including metformin as part of your weight loss treatment, you may want to familiarize yourself with the medicine and how it can affect your body while helping you to achieve that weight loss. Evidence is insufficient to conclude that metformin can serve as a treatment of overweight or grade I obesity in adults who do not have diabetes mellitus or polycystic ovary syndrome. Therefore, in most cases, there is little downside to increasing the dose to improve diabetes control. Metformin, when used alone, rarely causes hypoglycemia and is generally safe even in patients who do not have diabetes (8,9). However, the incremental effect of metformin when the dose is increased in persons taking less than a maximum dose is not clear. Metformin is widely recommended as first-line therapy for management of hyperglycemia in patients with type 2 diabetes (1). The choice between semaglutide and metformin was based on the patient's needs and preferences. The use of nicotine or cannabis was common in this population and was allowed, provided it remained stable throughout the course of the study. Furthermore, patients were excluded if they exhibited neurocognitive impairment, were using amphetamines or cocaine-related substances, were pregnant or lactating, or were of childbearing age and not using contraception. The treating clinicians were asked to prescribe either metformin or semaglutide, and they were similarly informed and required to consent to participate with their patient. The study was approved by the Mondriaan Mental Health Care Institutional Review Board (IRB no. CWO21017) and conducted in accordance with the Declaration of Helsinki and Good Clinical Practice. The ability to increase glucose metabolism may also contribute to the attenuation of obesity. Moreover, metformin may prevent obesity in mice by increasing metabolic activity of brown adipose tissue (BAT), a tissue with abundant mitochondria. Accumulating evidence suggests that metformin may be a potential therapy for obesity and its related metabolic dysfunctions. RANKL (receptor activator of nuclear factor kappa-B ligand) is important in the suppression of osteoclast proliferation and differentiation, which is inhibited by AMPK upon metformin treatment. Activity If you have arthritis symptoms and are taking metformin, your doctor may recommend that you continue treatment. Metformin is a biguanide, a type of sugar-lowering agent that works by decreasing the amount of glucose (sugar) in the body. Metformin is a prescription medication that has been used for diabetes for more than 50 years. This can help reduce cravings for sweets and other unhealthy foods that may be contributing to your weight problems. The result is better control over your blood sugar and a reduced risk of developing complications like heart disease and kidney disease. We also provide ongoing support through our secure patient portal, so you're never alone in your diabetes management journey. You can lessen the risk of getting lactic acidosis by avoiding excessive alcohol consumption and staying well hydrated. Risk factors include kidney or liver problems, severe illness, excessive alcohol use, and certain medications. Lactic acidosis is a rare but serious side effect that occurs when lactate builds up in your blood. Long-term metformin use can reduce vitamin B12 absorption, potentially leading to deficiency. Metformin for Weight Loss The American College of Physicians (ACP) recently suggested a target HbA1c value of 8.0% (64 mmol/mol) as appropriate for “most patients with type 2 diabetes” (12). Adherence to metformin therapy during run-in appeared to be strong in that 71.1% of participants reported no missed pills in the past week, and 27.1% reported missing only 0–20% (Table 1). Despite this, adherence and lifestyle modification alone cannot explain all of the improvement in HbA1c with optimization of dosage, because HbA1c fell significantly more in participants whose dose was increased by 1,000 mg/day, when compared with the group for which dose was unchanged (Fig. 1). Previous studies showed that high-sensitivity C-reactive protein is an independent risk factor for cardiovascular disease .The exact explanation for these disparate effects of metformin in different organisms remains elusive.Pre-disease is the recognition that the upper limits of normal (what we used to call high normal or borderline) for measurements such as blood pressure and blood glucose might pose a health risk and might be a warning that a patient is progressing toward overt hypertension or diabetes.Although the superiority of semaglutide over metformin could not be demonstrated due to the limited sample size, it can be concluded that semaglutide was at least as effective as metformin.However, this is not a healthy or sustainable way to lose weight.ARR—absolute risk reduction, CER—control event rate, CI—confidence interval, EER—experimental event rate, NNT—number needed to treat, RRR—relative risk ratio.Physicians may also prescribe metformin to non-diabetic individuals to help treat obesity and weight gain from taking antipsychotic medications (18). Concentrations of berberine that are effective in in vitro studies range between 10∼100 mM, which are thousands of times greater than those normally attainable following oral ingestion in human . In keeping with this, the concentrations required for AMPK activation in vitro are at mM levels. One explanation is that metformin is a cation and transport to mitochondria slowly, but accumulates there to high concentrations (100∼500 fold, i.e. 1∼5 mM), which is sufficient for AMPK activation . In this meta-analysis, they concluded that metformin appears to play a role in the reduction of liver cancer risk in type 2 diabetes patients. It is known that antiretroviral agents (HIV treatment) lead to devastating fats and other metabolic consequences such as insulin resistance, dyslipidemia, worsening of the blood glucose levels, and lipodystrophy . Nonetheless, metformin was found to reduce the levels of plasminogen activator inhibitor-1, and Von Willibrand factor from the unhealthy endothelium in patients with no underlying diabetes mellitus . Twelve diet-treated NIDDM women with obesity were randomly given two dose levels (850 mg or 1700 mg) of metformin or placebo at 0800 for three consecutive days followed by a meal test on the third day on three occasions using a 3x3 Latin square design. However, a subsequent multicentre, double-blind, and extendedfollow-up study is needed, which can clarify whether beinaglutide is suitable forthe long-term weight loss treatment in non-diabetics who areoverweight/obese. Three studies were short term from 12 weeks to 6 months 24,27,28 and three long-term multi-center studies lasted from 18 months to several years 23,25,26. Two independent reviewers (MS and II) assessed the quality of the included studies. The considered factors included random sequence generation and allocation concealment, description of drop-outs and withdrawals, blinding (participants, personnel, and outcome assessment), the integrity of the results, selective outcome reporting, and other bias . The quality of each study was assessed using the Cochrane ‘Risk of bias’ tool . ER formulations allow for once-daily dosing, which can improve adherence to the treatment regimen and generally result in fewer gastrointestinal side effects compared to IR options. Approximately 80% of individuals with type 2 diabetes are given metformin as part of their care plan. Metformin works by decreasing hepatic glucose production, improving insulin sensitivity, and enhancing peripheral glucose uptake. We included all the studies performed in children and adolescents, where metformin was used and compared with the placebo for the weight gain management in patients taking atypical antipsychotics. One of Morrison et al.’s earliest single group open label studies on off-label use of metformin showed that significant weight loss could occur in pediatric patients on psychotropic drugs treated with metformin (28). Current major guidelines recommend that when choosing antihyperglycemic treatments for patients who are overweight or have obesity, wherever possible, consideration should be given to medications that promote weight-loss or that are weight-neutral . Adverse events were documented based on patients' feedback on each of the 48 items listed on the UKU scale. To assess changes in physical complaints and side effects, we used the self-report version of the UKU Side Effect Rating Scale (UKU-SERS), a comprehensive side effect rating scale developed for use in clinical drug trials and routine clinical practice . In the event of adverse effects, the GP would be able to ensure that the adverse effects were adequately addressed. AP, antipsychotic; BMI, body mass index; GP, general practitioner; HbA1c, glycated haemoglobin; CRP, C-reactive protein; QoL, quality of life; UKU-SERS, UKU side effect rating scale; BPRS, brief psychiatric rating scale; ESM, experience sampling method Study participants Additionally, we included 45 untreated patients as controls. With treatment, most women with PCOS are able to get pregnant. Insulin is the hormone that controls the level of sugar in your blood. Metformin reduces the amount of sugar your liver releases into your blood. Members of Ivy RX branded medications were paid for their testimonials. This leads to better blood sugar control and decreased appetite, reducing calorie intake. Additionally, lifestyle modifications such as diet and exercise remain crucial components of a comprehensive weight management plan. Obtaining Metformin online requires a prescription from a licensed healthcare provider. Always follow the prescribing information and the advice of your healthcare provider regarding how to take Metformin. Therefore, it's important for patients to have their kidney function tested before starting Metformin and periodically thereafter. Further supporting tolerance to metformin, 90.7% of participants were at 2,000 mg/day (Table 1), and the mean dose at final screening was 1,932 mg/day. However, an association with race/ethnicity was not reported in other studies (25,26).Adherence to metformin therapy during run-in appeared to be strong in that 71.1% of participants reported no missed pills in the past week, and 27.1% reported missing only 0–20% (Table 1). Baseline HbA1c levels contributed independently both among participants whose dose was increased by ≥1,000 mg/day and for participants whose dose was not increased or increased by lesser amounts. However, that study compared different doses in different individuals, whereas we made dose adjustments within the same participants. Metformin primarily works by lowering blood sugar levels and improving insulin sensitivity, which can indirectly help some people lose weight. For people with type 2 diabetes or prediabetes, these effects can make weight loss easier. Many people wonder, does Metformin cause weight loss, or is it simply a medication for managing blood sugar? Metformin can lead to gradual and modest weight loss in some individuals, particularly those with insulin resistance or type 2 diabetes. To better understand Metformin’s role in both blood sugar control and weight management, it is important to explore its history, how it works, and its effects on the body. AMPK is an important regulator of mitochondrial biogenesis (20), hepatic and muscle fatty acid oxidation, glucose transport, insulin secretion, and lipogenesis (21). Since body weight did not increase, this suggests that central adiposity increased by redistribution of body fat. Long-term follow-up was excellent at 92%, in contrast with other weight loss drug trials (12). Among metformin participants, changes in hemoglobin and hematocrit occurred during the first year following randomization with no further changes observed over time. \"Until now, the way metformin, which is prescribed to control blood sugar levels, also brings about weight loss has been unclear,\" said Jonathan Long, PhD, an assistant professor of pathology. Case studies highlight the significance of a person-centered strategy in managing blood sugar levels, showing that personalized care plans including metformin can lead to enhanced health outcomes. It is essential to acknowledge that this medication is not FDA-approved specifically for weight reduction; its main indication is for controlling blood sugar levels in individuals with type 2 diabetes mellitus. Moreover, metformin suppresses bone cancer cell proliferation, migration, and invasion via the AMPK/mTOR/S6 or the MMP2/MMP9 signaling pathway (86). Because of the activation effect of AMPK, metformin could influence melanoma cell death and proliferation and the tumor microenvironment. Currently, two antibodies for the treatment of melanoma are available, i.e., ipilimumab (anti-CTLA-4) and nivolumab (anti-PD-1) (82). Their effects on BW reduction and improvement of insulin resistance could prevent or delay the onset of T2D. There were few cases of diarrhea – an adverse event frequently reported with metformin treatment – which could have been diminished by the constipating effect of mazindol. Furthermore, mazindol inhibits glucose intestinal absorption and decreases the activity of glucose-sensitive neurons located in the lateral hypothalamus, resulting in decreased gastric acid secretion, reduced appetite, and lower glucose levels . You also shouldn’t take a metformin dose on the same day as another medication that could harm the kidneys, such as the iodine-containing contrast medium (or dye) used in CT scans. Since metformin hasn’t been approved by the FDA for weight loss, there isn’t a standard recommended dosing for this purpose. When prescribed to counter weight gain from antipsychotic medications, metformin can be taken as immediate- or extended-release tablets. Long-acting insulin, for instance, works overnight or throughout the day to keep blood sugar levels even. Continuous glucose monitoring is an electronic system that records blood sugar levels every few minutes from a sensor put under the skin. Losing weight can help you manage blood sugar levels, cholesterol, triglycerides and blood pressure. Metformin is a first-line oral medication commonly prescribed to patients with type 2 diabetes or prediabetic patients with at least one cardiovascular disease risk factor, such as hypertension (high blood pressure).⁴ ⁵ Maximum weight loss is observed with higher doses and higher levels of insulin resistance. Some other studies have also indicated that this medication is a favorable weight-loss option for people who are overweight and have an increased risk of developing diabetes. Also, it increases the body’s sensitivity to insulin, a hormone responsible for managing blood glucose levels naturally. Furthermore, because an important goal was to obtain results with broad generalizability, the study did not standardize antipsychotic treatment or exclude concomitant medications with a risk for weight gain. With chronic metformin therapy, Walton et al25 reported a non-significant 21.3% increase in basal phosphorylated AMPK to total AMPK ratio. A decrease in AMPK activity that has been observed by Sharoff and colleagues14 does not match the finding of Kristensen et al24 who observed no significant difference in muscle AMPK activity following exercise with or without metformin. Sharoff et al14 found that insulin-resistant subjects who performed 30 minutes of exercise at 65% peak oxygen uptake (VO2max) followed by 10 minutes of exercise at 85% VO2max had a 52% increase in insulin sensitivity. In the case of metformin, inhibition of complex 1 of the electron transport chain simulates a low-energy state without an existent increase in energy demand, while in the case of exercise, demand for a greater energy output to accommodate an increasing workload, drives AMPK activation. The main difference between metformin and exercise is in the method of increasing the AMP-to-ATP ratio, subsequently influencing the AMPK. Metformin lowers glucose and reduces risk for diabetes in part through weight loss (2,7,16,17). Adherence to placebo did not affect weight loss, suggesting that metformin, rather than nonspecific adherence to positive health behaviors, was the relevant factor. Effects of metformin on weight have been reported in several trials in diabetes (2,3,13,14,15), one in obese adolescents (16), and in a recent meta-analysis (17). Distribution of adherence to metformin and placebo overall and by race/ethnicity and sex during the DPP (2 years) and for the DPP + DPPOS combined (9 years), and percent of the DPP/DPPOS participants achieving greater than 5% weight loss during each time period Weight loss was a strong predictor of diabetes prevention in both the metformin and placebo groups with weight loss accounting for 64% of the metformin versus placebo effect on diabetes prevention (7). The drug’s primary function is to lower the amount of glucose that a human liver releases at food intake. Taking medicines that doctors do not even prescribe for longer durations may give rise to other dangerous health problems. One should always practice something that has better long-term effects. This makes it completely different from the other drugs that people use to treat diabetes. All we can do is to reduce its effects or delay its consequences.