For many Type 2 diabetics, metformin is one of the most common medications used in diabetes management. In many cases, it is usually first prescribed when diet and exercise alone are insufficient to maintain healthy blood sugar levels. As a diabetic medicine, metformin lowers blood sugar production by improving how the body handles insulin release, making it a useful treatment for various types of diabetes. Of course, like many prescription drugs, metformin also has several side effects that can affect the body in significant ways. Many adults that take metformin for diabetes commonly report experiencing issues such as stomach aches and diarrhea. However, one side effect–weight loss–has proven beneficial to some patients hoping to lose a few extra pounds.
Although losing weight is a common side effect of most diabetic medications, metformin has other unique mechanisms of action that make it a promising weight loss treatment for non-diabetic patients struggling with obesity. 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.
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. We’ll also go over the risks and side effects of using metformin so you can make a more informed decision on whether the medicine will work as a viable treatment option for your weight-loss goals.
What Is Metformin?
Metformin is an FDA-approved 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. 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. In addition, many physicians also use metformin as a preventative treatment for prediabetes, a condition in which blood sugar levels are higher than normal but not enough to be diagnosed as type 2 diabetes, to keep the health issue from further progressing.
Aside from managing blood sugar levels, metformin is also useful in treating various health conditions. For example, physicians typically prescribe metformin as an off-label treatment for women struggling with polycystic ovary syndrome (PCOS); a hormonal disorder where the ovaries and adrenal glands secrete an abnormal amount of androgens (male sex hormones), causing the women’s ovaries to become enlarged with small cysts. Due to its ability to lower and regulate glucose levels, metformin has also shown great potential in stimulating weight loss, prompting many physicians to prescribe the medication as an off-label treatment for weight gain and obesity.
How Does Metformin Work To Lower Blood Sugar?
Similar to other diabetes drugs, metformin works to improve the insulin resistance commonly associated with diabetic conditions by increasing your body’s response to the insulin your pancreas releases during food consumption. 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.
But that’s not the only way that metformin can lower your glucose. Once you’ve finished eating, metformin continues to reduce the amount of blood sugar the intestines absorb during meals, which also decreases the concentration of glucose that will eventually travel through the bloodstream to other regions of the body. During this process, metformin will also work to decrease the amount of blood sugar produced by other organs–such as the liver–to further reduce the body’s natural blood sugar production, ensuring that glucose levels remain within healthy parameters. As a result, the body can fully utilize the sugars obtained during food consumption and break down calories into energy more efficiently, allowing the body to maintain low blood sugar levels consistently as you consume food.
How Does Metformin Cause Weight Loss?
Metformin can invoke and even improve several biological processes inside the body that can stimulate weight loss, which include:
Regulating and Reducing Appetite
Metformin can help to control your appetite in several ways. 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. In doing so, leptin manages your food intake, making it easier to regulate energy expenditure and burn off the energy stored in your fat tissue, which can help you maintain a normal body weight.
Metformin also increases the secretion of GLP-1, a hormone produced in the gut which also works as an appetite suppressant by slowing down gastric emptying during digestion, leading to feelings of fullness in the stomach. As a result of its effects on leptin and GLP-1, metformin creates a dualistic mechanism of action that provides better control over your appetite and inhibits unnecessary food cravings that lead to overeating, which, in turn, allows you to significantly decrease your food intake and avoid unnecessary calories so it’s easier for you to lose weight.
Improving Insulin Sensitivity
Metformin improves insulin sensitivity by activating the post-receptor insulin signaling pathways that allow insulin to travel to other parts of the body, such as muscle tissue. In doing so, metformin makes it easier for insulin to move glucose more effectively through the bloodstream so it can be used as energy. This process can also help to reduce your blood sugar levels, which has been shown to help induce weight loss.
Enhancing Your Gut Microbiome
Your gut microbiome is the area of the stomach where essential microorganisms exist to break down large molecules of the foods you consume, which can also make you feel more satisfied with your meal after digestion. Metformin can work to optimize the microbiome environment that contains these micro-organisms and further improve the body’s ability to break down food and utilize energy more efficiently, thus helping to promote effective digestion and a healthy gut balance that can also aid in increasing weight loss.
Can a Non-Diabetic Take Metformin to Lose Weight?
Currently, metformin isn’t FDA-approved as a weight loss drug for the general public. However, 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.
What Is The Best Dosage For Non-Diabetics To Achieve Weight Loss With Metformin?
Generally, there isn’t an official dosing schedule to follow when prescribing metformin off-label as a weight loss treatment for non-diabetics, so your physician will ultimately be the one to decide what may be the best dosage to effectively work with your body and help you achieve your weight loss goals. Typically, a physician will review your medical history to determine the best metformin dosage for your case. However, in most cases, doctors usually start patients off with a low dose of metformin so that the body can gradually adjust to the medication before slowly increasing the dosage over the next few weeks of treatment.
How Much Weight Can I Lose With Metformin?
Ordinarily, the amount of weight loss you achieve with metformin will depend on the severity of your weight gain and how your body may respond to treatment. However, studies reveal that obese and overweight patients with a BMI (body mass index) greater than 27 kg lost between 5.6 to 6.5 % of their original body weight after six months of using metformin.
Are There Any Side Effects From Taking Metformin?
As previously mentioned, taking metformin as a weight loss treatment can lead to several side effects, including:
- Nausea and vomiting
- Cramps or stomach discomfort
- Muscle aches and pains
- Bloating
- Heartburn
- Indigestion
- Diarrhea
In many cases, these temporary side effects will typically lessen over time as you continue to progress through treatment. To make things easier, you should also take your metformin along with your meals, as food consumption can also help the stomach digest the medicine more efficiently and reduce your chances of experiencing side effects.
Always make sure to notify your physician if the side effects continue to persist or worsen during treatment. They can adjust the dosage or prescribe other versions of metformin–which we will discuss later in the article–that may make it easier to avoid unwanted complications.
What Are The Health Risks Associated With Metformin?
In addition to the side effects, several health risks can accompany metformin for certain patients.
For example, metformin can lead to an increased risk for hypoglycemia when taken with other glucose-lowering medications such as insulin and sulfonylureas. So, if you have diabetes, you’ll need to discuss the use of other antidiabetic medicines with your physician before you incorporate metformin into your daily medication regimen.
Metformin also has the potential to reduce the amount of Vitamin B12 that the body will typically absorb from food consumption, which may lead to B12 deficiency. Unfortunately, decreased levels of B12 can also lower your blood cell count and increase the risk of anemia, which can cause additional symptoms such as muscle weakness, fatigue, and pale skin. Metformin is more likely to increase the risk of experiencing B12 deficiency if you’ve previously had gastrointestinal surgery, stomach complications that affected your B12 absorption, or if you avoid animal products and rely primarily on a vegan diet. Older patients that take metformin may also have an increased risk of experiencing B12 deficiency.
In addition to hypoglycemia and B12 deficiency, metformin may also cause lactic acidosis–a medical condition where the lactic acid produced in the muscle tissue accumulates in the bloodstream. Typically, lactic acidosis occurs due to an abnormal increase in lactic acid production or when the body cannot effectively filter lactic acid from the liver and kidney. Lactic acidosis will usually lead to symptoms such as cold skin and breathing difficulties that can either appear suddenly or gradually over the course of a few days, which is why many physicians recommend that you monitor your body for any of these symptoms as you continue to use metformin.
For the most part, many patients who take metformin will rarely experience lactic acidosis. However, some adults may have an increased risk of developing lactic acidosis if they have pre-existing conditions such as previous heart failure, reduced kidney function, or liver disease. Adults who engage in excessive alcohol consumption also face an increased risk of developing lactic acidosis while taking metformin.
Patients preparing to have x-rays, CT scans, or specific types of surgery may need to temporarily discontinue metformin since the dye commonly used in these medical procedures can also increase the risk of lactic acidosis. It is also important to inform your doctor if you’ve developed lactic acidosis in the past before taking metformin, as the medication may not be a viable treatment option, given your medical history. In this instance, your physician may recommend trying other alternative weight-loss treatments to help you reach your goals.
Metformin may also stimulate ovulation and cause unintended pregnancy in premenopausal women. Fortunately, metformin is typically safe during pregnancy and even combined with insulin for expecting mothers with Type 2 diabetes. However, metformin may also increase the severity of the mild side effects–such as diarrhea, nausea, vomiting, and other gastric issues–in some women during pregnancy.
Disclose your medical history and discuss the potential side effects and health risks with your physician before taking metformin. You should also report any life changes or sudden symptoms you may experience during treatment to your healthcare provider. They can determine whether or not an adjusted dose is required or if you should discontinue treatment completely to preserve your health.
Who Shouldn’t Take Metformin?
Unfortunately, metformin may cause complications for patients with more severe health issues. In fact, many physicians will regularly recommend that adults avoid taking metformin if they already suffer from pre-existing medical conditions such as:
- Congestive heart failure
- Kidney disease
- Diabetic ketoacidosis
- Liver disease
- Metabolic acidosis
It is crucial that you disclose any pre-existing health complications with your primary physician if you’re considering taking metformin. With that essential information, your healthcare provider can recommend other weight-loss treatments more sensitive to your current health issues.
How Do I Use Metformin?
Metformin is available as a tablet, liquid, or powder, so if you decide to proceed with treatment, you will first need to decide which would be the best method for your body to ingest the medication comfortably.
Tablets
Metformin tablets have various strengths, which usually vary between 500mg, 850mg, and 1,000 mg dosages. As mentioned, your doctor will decide which of these will be the best dosage for your body to help you lose weight. The tablets are also available in two forms: instant and extended-release. Standard or instant release (IR) tablets typically release metformin immediately upon digestion and usually lasts about 5 hours, so it must be taken 1-3 times a day, depending on your prescribed dosage. On the other hand, metformin extended-release (ER) tablets slowly release the medicine inside the body over the course of 12 hours, which can help your body digest the medicine more effectively and reduce the risk of experiencing adverse side effects.
Since the metformin extended-release tablet lasts seven more hours than the instant-release version, you will only need to take it once daily with a meal, preferably in the evening. It’s important to note that as you take the extended-release tablets, you may also find part of the tablet has passed into your stool after your body has absorbed the medicine. It is usually normal for patients to find a part of the tablet inside their stool, and it typically poses no cause for concern, so try not to worry if this occurs after each dose.
Although you can crush or even split immediate-release metformin tablets to manage your doses throughout the day, you should not do the same with the extended-release version. Chewing, crushing, or breaking a metformin extended-release tablet will release the drug all at once, which can increase the risk of side effects and even change how the medication works inside your body, so avoid breaking it down as much as possible. For this reason, it is strongly advised that you swallow metformin extended-release tablets whole along with a glass of water as you eat. You should also continue drinking plenty of water throughout the day after swallowing metformin, as the medicine may leave you dehydrated. Doing so can also help you avoid further complications during treatment.
Make sure to inform your doctor if you are having trouble swallowing either version of the metformin tablets. They will likely recommend that you try the liquid or powder form of metformin to make it easier for you to ingest the medicine.
Liquid Metformin
Much like its tablet form, liquid metformin is available in immediate or extended-release and also comes in 500 mg, 850 mg, and 1000 mg dosages. However, unlike the metformin tablets, you will need to take a few extra steps to prepare a liquid dose for consumption. To ensure you ingest the proper amount required for your prescription, you must measure the liquid with a measuring spoon, medicine cup, or syringe. Do not use the average household spoon, as it may not be large enough to hold the proper amount of liquid. When measuring the liquid form of extended-release metformin, you should also use the dosing cup supplied with the medicine. Make sure to ask your physician for a dosing cup if you aren’t provided with the proper measuring utensils to accurately measure the metformin solution.
Metformin Powder
If you prefer liquid metformin over tablets but are unable to obtain the pre-packaged solution, you can also purchase a powdered version of the medicine and mix it with water. In taking this route, you’ll receive a box of sachets–small pouches or bags–each containing the amount of Metformin powder prescribed by your physician. When preparing your daily dose, simply open the sachet, pour the powder into a glass, and add 150 ml of water to get started. Then stir the solution until the water becomes clear or cloudy, and drink the medicine immediately after you’ve finished mixing.
Regardless of which option you choose, you should remember to take Metformin at the same time every day for consistency. Doing this can help ensure that you receive the best results.
If you miss your scheduled time for a dose, try to take it as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and resume your regular dosing schedule. Do not attempt to double dose to make up for a missed one, as it may cause unwanted adverse reactions.
Can I Take Metformin With Other Weight Loss Medications?
It is usually safe to take metformin along with other weight loss medications. In some cases, many physicians will even integrate metformin and weight loss medications into a combination or polytherapy to further enhance the effectiveness of your prescribed weight loss treatment. Of course, taking both at the same time can also increase the risk and severity of certain gastrointestinal side effects such as nausea, vomiting, and diarrhea, so make sure to discuss these potential circumstances with your physician before including both medications in your weight-loss treatment.
Start Your Metformin Treatment At Renew Vitality
When using diabetic medications like metformin to treat weight-related conditions such as obesity, it is always important to seek out medical professionals that can accurately prescribe an appropriate dosage that will fit your biological specifications, so you can reach your weight loss goals without experiencing serious complications.
At Renew Vitality, our physicians meticulously study your physiology and medical history to prescribe a metformin dosage that can effectively help manage your appetite, so you can comfortably lose weight without an increased risk of side effects. In addition, our wellness experts will also work with you to create a customized fitness and diet routine that can help you transition to a healthier lifestyle so you can maximize the effects of your treatment and obtain the best weight loss results.
If you’re tired of struggling with your excess weight gain and are finally ready to shed those extra pounds, then it may be time to visit Renew Vitality and get started on a metformin treatment plan. Call 1-888-785-3940 and schedule a consultation at any of our Renew Vitality clinics in the United States and speak to one of our specialists to learn more about how metformin can help you achieve your weight-loss goals.
References:
- Effectiveness of metformin on weight loss in non-diabetic individuals with obesity
- Effect of Semaglutide on the Pharmacokinetics of Metformin, Warfarin, Atorvastatin and Digoxin in Healthy Subjects
- Beneficial effects of metformin on energy metabolism and visceral fat volume through a possible mechanism of fatty acid oxidation in human subjects and rats
- Can Metformin Help with Weight Loss?
- Can the Miracle Drug Metformin Also Help You Lose Weight?
- Metformin
- What Are the Side Effects of Metformin?
- What Is Metformin Used for, and How Does It Work Exactly?
- Metformin HCL – Uses, Side Effects, and More
- How and when to take metformin
FAQ
How many times a day should I take Metformin to lose weight?
That will depend on how your body responds to medication and the type of metformin used during treatment. If you choose the immediate-release version of metformin, your physician may recommend that you take the medicine with a meal 1-3 times a day. However, if you choose the extended-release version, you will usually only need to take it once daily.
What should I do if I’m losing too much weight on metformin?
Metformin typically induces small amounts of weight loss, which occurs gradually as you continue to progress through treatment. If you're losing too much weight or losing weight too fast while taking metformin, make sure to consult with your physician immediately, as there may be other unknown factors causing the accelerated weight loss.
Can Metformin eliminate stomach fat?
Yes, it can. Metformin treatment has been found to upregulate enzymes that affect fat oxidation in the stomach and significantly reduce visceral fat mass in the abdominal cavity, thus leading to less stomach fat and decreased weight circumference.
