Metformin is often prescribed for people with type 2 diabetes to control their blood sugar level. Type 2 diabetics are not non-insulin dependent like people with type 1 diabetes, but they cannot properly produce enough insulin or use it effectively. Weight loss is common when using Metformin, but can vary from person to person based on a few factors.
Metformin primarily works to reduce the creation of glucose, a simple sugar molecule, from the liver. It does so by activating a liver enzyme called AMP-activated protein kinase. When this enzyme is activated and has an increased presence, the body’s overall insulin activity improves, which helps reduce sugary glucose in the blood.
Expecting Weight Loss
According to Redbookmag.com, metformin is also being prescribed by obesity specialists to aid weight loss in type 2 diabetics. It is well known that obesity and type 2 diabetes have a relatively strong relationship. Those who are obese are much more likely to experience a decrease in insulin sensitivity and eventually become diagnosed with type 2 diabetes. Metformin, when combined with lifestyle interventions, will usually result in a moderate amount of weight loss.
Metformin acts on the insulin pathway. When the medication improves the pathway, the body is able to produce insulin at a more normal level. This helps reduce the increase in appetite that can occur when type 2 diabetes goes untreated. Furthermore, the improvement of the insulin pathway by Metformin results in an increased burning of fat cells. This decreases the amount of calories converted into fat cells for storage by your liver and helps return your fat oxidation pathway to a more normal state of operation.
The majority of studies regarding weight loss in obese and type 2 diabetic patients lasted longer than 4 months. Often, these studies lasted six to seven months in total and, when taking into account that Metformin induced weight loss is a general and modest 1 to 4 kg, it may not be uncommon for progress in weight reduction to occur only after four to six weeks. The American College of Sports Medicine notes in the “ACSM’s Exercise Management for Persons with Chronic Diseases and Disabilities” that the combination of Metformin and exercise training requires caution in the timing of the medication, the timing of food intake and the monitoring of blood glucose levels before and after exercise. This increased caution and care when taking Metformin and exercising regularly is due to the possibility of the patient experiencing a dangerous drop in glucose levels during or after bouts of exercise.
Weight Loss to Expect
In “Diabetes Mellitus” by Ellenberg, Rifkin, Porte Jr., Sherwin and Baron, Metformin resulted in 2 to 3 kg of weight loss in the first six months of treatment in most studies. Similarly, in “Handbook of Obesity” by George Bray and Claude Bouchard, an overview of a study comparing Metformin with a placebo in 324 subjects with obesity and insulin resistance found that subjects on Metformin lost an additional 1 to 2 kg of weight than the placebo group. Bray and Bouchard also indicate that in a Metformin study consisting of type 2 diabetic subjects, those who took Metformin lost an average of 3.8 kg. Overall, obese and type 2 diabetic patients who take Metformin should expect a 1 to 4 kg decrease in weight.