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Effects of metformin on weight loss: potential mechanisms
Abstract
PURPOSE OF REVIEW: Despite the known glucose-lowering effects of metformin, more recent clinical interest lies in its potential as a weight loss drug. Herein, we discuss the potential mechanisms by which metformin decreases appetite and opposes unfavorable fat storage in peripheral tissues. RECENT FINDINGS: Many individuals struggle to maintain clinically relevant weight loss from lifestyle and bariatric surgery interventions. Long-term follow-up from the Diabetes Prevention Program demonstrates that metformin produces durable weight loss, and decreased food intake by metformin is the primary weight loss mechanism. Although the effect of metformin on appetite is likely to be multifactorial, changes in hypothalamic physiology, including leptin and insulin sensitivity, have been documented. In addition, novel work in obesity highlights the gastrointestinal physiology and circadian rhythm changes by metformin as not only affecting food intake, but also the regulation of fat oxidation and storage in liver, skeletal muscle, and adipose tissue. SUMMARY: Metformin induces modest weight loss in overweight and obese individuals at risk for diabetes. A more detailed understanding of how metformin induces weight loss will likely lead to optimal co-prescription of lifestyle modification with pharmacology for the treatment of obesity independent of diabetes.
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“prevent weight gain by influencing appetite regulatory pathways in the brain (8).”
From Metformin and Combined Oral Contraceptive Pills in the Management of Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis (2024) · cites this paper as [8]
In the citing paper
“Aside from the mechanisms summarized in two reviews (77, 78), recent study findings indicate that GDF-15 plays an independent role in body weight change in people taking metformin.”
From GDF-15 as a Weight Watcher for Diabetic and Non-Diabetic People Treated With Metformin (2020) · cites this paper as [77]
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“Studies have suggested that metformin might reduce weight through appetite regulatory pathways in the brain, leading to decreased food uptake.50”
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Metadata
- Authors
- Malin, S. K., & Kashyap, S. R.
- Affiliations
- Cleveland Clinic (US)
- Corresponding author
- Kashyap, Sangeeta R.
- Venue
- Current Opinion in Endocrinology, Diabetes & Obesity
- Published
- 2014-10
- Volume
- 21
- Issue
- 5
- Pages
- 323-329
- ISSN
- 1752-296X (ISSN-L)
- OpenAlex
- W2118790125
- Cited by
- 223
- References
- 43
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 16 · 2023: 18 · 2022: 16 · 2021: 33 · 2020: 27 · 2019: 27 · 2018: 34 · 2017: 15 · 2016: 12 · 2015: 10
- FWCI
- 1.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Opinion in Endocrinology Diabetes and Obesity (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK089547)
- National Center for Research Resources (K12RR023264)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Pharmacology and Obesity Treatment
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Keywords
- metformin, weight loss, obesity, appetite, dietary intake, leptin, insulin sensitivity, fat oxidation, fat deposition, circadian rhythm, digestive physiology, diabetes prevention, lifestyle modification
- MeSH terms
- Appetite Depressants, Diabetes Mellitus, Type 2, Eating, Humans, Hypoglycemic Agents, Hypothalamus, Insulin Resistance, Metformin, Obesity, Signal Transduction, Weight Loss, Treatment Outcome, Leptin, Risk Reduction Behavior
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