Metformin For Weight-Loss & More
Metformin: More Than Just a Diabetes Drug. Discover its off-label uses for weight loss, cardiovascular health, and more. Speak with your doctor to see if it’s right for you.
Metformin Without Diabetes?
Metformin is a diabetes drug; it works by:
- decreasing glucose absorption from the gut
- decreasing glucose production in the liver
- increasing glucose sensitivity
It doesn’t change how much insulin is secreted, and is unlikely to cause hypoglycemia, making it relatively safe as diabetes drugs go.
It’s a biguanide drug, and/but so far as science knows (so far), its mechanism of action is unique (i.e. no other drug works the same way that metformin does).
Today we’ll examine its off-label uses and see what the science says!
A note on terms: “off-label” = when a drug is prescribed to treat something other than the main purpose(s) for which the drug was approved.
Other examples include modafinil against depression, and beta-blockers against anxiety.
Why take it if not diabetic?
There are many reasons people take it, including just general health and life extension:
However, its use was originally expanded (still “off-label”, but widely prescribed) past “just for diabetes” when it showed efficacy in treating pre-diabetes. Here for example is a longitudinal study that found metformin use performed similarly to lifestyle interventions (e.g. diet, exercise, etc). In their words:
❝ Lifestyle intervention or metformin significantly reduced diabetes development over 15 years. There were no overall differences in the aggregate microvascular outcome between treatment groups❞
But, it seems it does more, as this more recent review found:
❝Long-term weight loss was also seen in both [metformin and intensive lifestyle intervention] groups, with better maintenance under metformin.
Subgroup analyses from the DPP/DPPOS have shed important light on the actions of metformin, including a greater effect in women with prior gestational diabetes, and a reduction in coronary artery calcium in men that might suggest a cardioprotective effect.
Long-term diabetes prevention with metformin is feasible and is supported in influential guidelines for selected groups of subjects.❞
Source: Metformin for diabetes prevention: update of the evidence base
We were wondering about that cardioprotective effect, so…
Cardioprotective effect
In short, another review (published a few months after the above one) confirmed the previous findings, and also added:
❝Patients with BMI > 35 showed an association between metformin use and lower incidence of CVD, including African Americans older than age 65. The data suggest that morbidly obese patients with prediabetes may benefit from the use of metformin as recommended by the ADA.❞
We wondered about the weight loss implications of this, and…
For weight loss
The short version is, it works:
- Effectiveness of metformin on weight loss in non-diabetic individuals with obesity
- Metformin for weight reduction in non-diabetic patients: a systematic review and meta-analysis
- Metformin induces weight loss associated with gut microbiota alteration in non-diabetic obese women
…and many many more where those came from. As a point of interest, it has also been compared and contrasted to GLP-1 agonists.
Compared/contrasted with GLP-1 agonists
It’s not quite as effective for weight loss, and/but it’s a lot cheaper, is tablets rather than injections, has fewer side effects (for most people), and doesn’t result in dramatic yoyo-ing if there’s an interruption to taking it:
Or if you prefer a reader-friendly pop-science version:
Ozempic vs Metformin: Comparing The Two Diabetes Medications
Is it safe?
For most people yes, but there are a stack of contraindications, so it’s best to speak with your doctor. However, particular things to be aware of include:
- Usually contraindicated if you have kidney problems of any kind
- Usually contraindicated if you have liver problems of any kind
- May be contraindicated if you have issues with B12 levels
See also: Metformin: Is it a drug for all reasons and diseases?
Where can I get it?
As it’s a prescription-controlled drug, we can’t give you a handy Amazon link for this one.
However, many physicians are willing to prescribe it for off-label use (i.e., for reasons other than diabetes), so speak with yours (telehealth options may also be available).
If you do plan to speak with your doctor and you’re not sure they’ll be agreeable, you might want to get this paper and print it to take it with you:
Off-label indications of Metformin – Review of Literature
Take care!
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