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Does Metformin Work for Weight Loss?

October 17, 2024
4 mins

Obesity is one of the most common health conditions in the United States. Losing weight involves more than just adjusting your diet; it encompasses fitness, lifestyle changes, and various medications that can provide additional support in reaching your weight loss goals. Metformin is a medication that may offer additional support in helping you reach your weight loss goals.

Metformin is one of the most popular medications for type 2 diabetes. However, it has also received attention for its weight loss benefits. While it’s not an FDA-approved weight loss drug, metformin provides several benefits for managing blood sugar and other processes important for healthy weight loss.

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What is Metformin?

Metformin is the generic name for an oral medication used for treating type 2 diabetes. It’s sold under many brand names including Axpinet, Glucophage, and Metabet.

Metformin targets the liver and gut to reduce high blood sugar levels. It can also help prevent diabetes in people with an increased risk of developing the condition. Additionally, metformin can be part of a diabetes treatment plan that promotes weight loss in individuals with obesity.

How Metformin Works for Weight Loss

High blood sugar levels can often contribute to weight gain. Metformin helps control weight gain by preventing high blood sugar levels and reducing appetite.

Engaging in physical activity daily and following a well-balanced diet while taking metformin is key for maintaining weight loss results.

In some studies, metformin led to weight loss by managing the effects of the GDF15 (growth differentiation factor) protein in the body. People may see high GDF15 levels when developing chronic health conditions or being in high-stress environments.

What does metformin do for drug-related weight gain?

Weight gain is a common side effect of antipsychotic drugs like olanzapine (Zyprexa) and clozapine (Clozaril). One of the main purposes of these drugs is to treat certain mental health conditions including schizophrenia, and borderline personality disorder. People taking these medications found that using metformin helped counteract the weight gain from these medications and support weight loss.

What does metformin do for PCOS-related weight gain?

PCOS is a hormonal imbalance that can cause cysts to form on the ovaries. Women with polycystic ovary syndrome (PCOS) may experience weight loss and improvements in insulin resistance after using metformin.

Metformin Dosage for Weight Loss

Metformin is an oral medication that should be taken with food. Be sure to speak with a healthcare provider about the proper dosage for you. 

Recommended metformin dosages can range from 500 to 2,550 milligrams (mg). Smaller-scale studies have suggested that doses over 1,500 mg may be more effective in promoting weight loss.

The type of tablet prescribed to you determines how often the medication is taken. Extended-release tablets are taken once a day with food and water, while immediate-release tablets are taken twice a day. Metformin can also be taken in liquid form with food.

It’s not uncommon for a healthcare provider to recommend increasing your dosage over time. A healthcare provider may increase your dosage in 500 mg increments to help prevent gastrointestinal symptoms. However, this is not always the case. At most, a healthcare provider may recommend up to 2,000 mg daily.

How long does metformin stay in your system?

Metformin starts working in the body as early as three hours after taking a tablet. The drug may begin to dissolve after around 20 hours. The drug leaves the body through urination.

Benefits of Metformin for Weight Loss

Metformin protects cells from damage and may prevent the growth of tumors that could cause breast, liver, pancreatic, and other types of cancer.

This type of drug primarily operates in your liver. It can minimize the risk of liver damage and liver fatty disease.

Untreated type 2 diabetes can increase your risk for heart failure. If you have diabetes, taking metformin protects the body from heart failure and other cardiovascular conditions.

Risks

A healthcare provider won’t prescribe metformin if you have kidney disease or are taking certain medications.

While taking metformin, it’s important to stay hydrated. Drinking large amounts of alcohol while on metformin can lead to dehydration and other serious side effects like lactic acidosis (a build-up of lactic acid in the bloodstream) and hypoglycemia (low blood sugar).

Side Effects

Common side effects of metformin include:

  • Diarrhea

  • Nausea

  • Upset stomach

  • Vomiting

  • Headache

  • Dizziness

  • Itchiness

In some cases, you may also experience a metallic taste in your mouth. Studies show it is possible for men to experience erectile dysfunction after starting metformin, but it’s rare. It’s important to stay aware of any serious symptoms. If you are experiencing chest pains, seek medical attention right away. This could be a sign of a medical emergency.

Who shouldn’t take metformin?

In some cases, a licensed healthcare provider may suggest using metformin in combination with other type 2 diabetes treatments. Be sure to notify your healthcare provider of all of the medications you are taking, as some medications are not safe to take while taking metformin.

The following medications may interact negatively with metformin:

  • Diamox (acetazolamide)

  • Keveyis (dichlorphenamide) 

  • Neptazane (methazolamide)

  • Topamax (topiramate)

  • Zonegran (zonisamide)

Metformin may also be a risky medication for those over 65 with a history of:

  • Heart attack: Also known as myocardial infarction, a complication where blood flow to the heart is blocked

  • Stroke: Insufficient blood flow to the brain that may lead to long-term brain damage

  • Diabetic ketoacidosis: A potentially fatal complication that causes a buildup of ketones in the liver

  • Heart disease: A group of health conditions that can disrupt the flow of blood to the heart and surrounding blood vessels

  • Liver disease: A wide range of conditions that harm liver function

Cost and Shortages

Metformin is one of the more affordable diabetic medications. Prescription costs for metformin can range from an estimated $5 to $305, depending on the brand and whether or not you have health insurance. Different types of health insurance may have a wide range of price options for metformin as well. 

Due to high demand, the availability of metformin is currently limited. Fortunately, if you’re looking to lose weight, there are plenty of FDA-approved options for weight loss specifically.

Alternatives to Metformin for Weight Loss

The intended use of metformin is to treat type 2 diabetes. Weight loss is a common side effect of the drug, but it’s not its main purpose. However, there are medications that are primarily aimed at promoting weight loss.

Common popular weight loss medications contain either semaglutide or tirzepatide. Popular weight loss medications include Wegovy® (semaglutide) and Zepbound® (tirzepatide).

Complementary medicine alternatives

Be sure to consult your healthcare provider if you’re considering taking additional medications to lose weight. Metformin may be more effective for weight loss when factored into a treatment plan that includes other medications.

Some healthcare providers may recommend using metformin in combination with other medications including:

  • Wellbutrin (bupropion)

  • Lomaira (phentermine)

  • Topiramax (topiramate)

Wellbutrin (bupropion) is a generic medication typically prescribed to treat depression. However, it may also have some weight loss effects.

Using three medications together is a regimen also known as triple therapy. Your healthcare provider can provide the proper dosages for each drug.

Be sure to let them know right away if you experience any symptoms. Since metformin is not a drug developed specifically for weight loss, consult your healthcare providers about additional options for weight loss treatment.

How Rex MD Can Help

The Rex MD Weight Management Program may be able to help you achieve your weight loss goals. If you qualify, you’ll gain access to prescriptions for groundbreaking GLP-1 medications like compounded semaglutide along with clinical oversight, metabolic testing, and ongoing support from licensed healthcare providers to improve your overall health.

There’s no commitment to get started. See if you qualify to lose weight with Rex MD.

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