Metformin: an Old Therapy that Deserves a New Indication for the Treatment of Obesity

Metformin is not currently used for weight loss or diabetes prevention because it lacks an FDA indication for obesity and/or pre-diabetes treatment. Based on the evidence, metformin has been shown to decrease the incidence of type 2 diabetes, and compares favorably to other weight-loss medications in terms of efficacy as well as safety. Thus, metformin should be considered for a treatment indication in patients with these conditions.

[1]  J. Chan,et al.  Metabolic and Hemodynamic Effects of Metformin and Glibenclamide in Normotensive NIDDM Patients , 1993, Diabetes Care.

[2]  R. DeFronzo,et al.  Efficacy of metformin in patients with non-insulin-dependent diabetes mellitus. The Multicenter Metformin Study Group. , 1995, The New England journal of medicine.

[3]  M. Safar,et al.  The Effect of Metformin on the Metabolic Abnormalities Associated With Upper-Body Fat Distribution. BIGPRO Study Group , 1996, Diabetes Care.

[4]  R. Holman,et al.  Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34) , 1998, The Lancet.

[5]  Paolisso,et al.  Effect of metformin on food intake in obese subjects , 1998, European journal of clinical investigation.

[6]  P. Rasuli,et al.  Metformin and contrast media: where is the conflict? , 1998, Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes.

[7]  C. Glueck,et al.  Metformin-induced resumption of normal menses in 39 of 43 (91%) previously amenorrheic women with the polycystic ovary syndrome. , 1999, Metabolism: clinical and experimental.

[8]  T. Baptista.  Body weight gain induced by antipsychotic drugs: mechanisms and management , 1999, Acta psychiatrica Scandinavica.

[9]  R. Holman,et al.  Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus: progressive requirement for multiple therapies (UKPDS 49). UK Prospective Diabetes Study (UKPDS) Group. , 1999, JAMA.

[10]  E. Mannucci,et al.  Effect of metformin on glucagon-like peptide 1 (GLP-1) and leptin levels in obese nondiabetic subjects. , 2001, Diabetes care.

[11]  C. Glueck,et al.  Metformin reduces weight, centripetal obesity, insulin, leptin, and low-density lipoprotein cholesterol in nondiabetic, morbidly obese subjects with body mass index greater than 30. , 2001, Metabolism: clinical and experimental.

[12]  S. Fowler,et al.  Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. , 2002 .

[13]  E. Salpeter,et al.  Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus. , 2003, The Cochrane database of systematic reviews.

[14]  J. Born,et al.  Modulation of hunger by plasma glucose and metformin. , 2003, The Journal of clinical endocrinology and metabolism.

[15]  N. Sattar,et al.  Metformin and weight loss in obese women with polycystic ovary syndrome: comparison of doses. , 2005, The Journal of clinical endocrinology and metabolism.

[16]  J. Huh,et al.  Metformin restores leptin sensitivity in high-fat-fed obese rats with leptin resistance. , 2006, Diabetes.

[17]  Huiman X Barnhart,et al.  Clomiphene, metformin, or both for infertility in the polycystic ovary syndrome. , 2007, The New England journal of medicine.

[18]  Jing-ping Zhao,et al.  Lifestyle intervention and metformin for treatment of antipsychotic-induced weight gain: a randomized controlled trial. , 2008, JAMA.

[19]  Alicia R. Desilets,et al.  Role of Metformin for Weight Management in Patients Without Type 2 Diabetes , 2008, The Annals of pharmacotherapy.

[20]  S. Ishibashi,et al.  Metformin, but not pioglitazone, decreases postchallenge plasma ghrelin levels in type 2 diabetic patients: a possible role in weight stability? , 2008, Diabetes, obesity & metabolism.

[21]  Wenbin Guo,et al.  Metformin addition attenuates olanzapine-induced weight gain in drug-naive first-episode schizophrenia patients: a double-blind, placebo-controlled study. , 2008, The American journal of psychiatry.

[22]  S. Schinner,et al.  Effects of Intensive Glucose Lowering in Type 2 Diabetes , 2009 .

[23]  E. Finkelstein,et al.  Annual medical spending attributable to obesity: payer-and service-specific estimates. , 2009, Health affairs.

[24]  David M Nathan,et al.  10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. , 2009, Lancet.

[25]  A. Donker,et al.  Long-term effects of metformin on metabolism and microvascular and macrovascular disease in patients with type 2 diabetes mellitus. , 2009, Archives of internal medicine.

[26]  M. Hasnain,et al.  Metformin for Atypical Antipsychotic-Induced Weight Gain and Glucose Metabolism Dysregulation , 2010, CNS drugs.

[27]  A. Donker,et al.  Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency: randomised placebo controlled trial , 2010, BMJ : British Medical Journal.

[28]  L. Pellerin,et al.  The anorexigenic effects of metformin involve increases in hypothalamic leptin receptor expression. , 2011, Metabolism: clinical and experimental.

[29]  Advantages of Extended-Release Metformin in Patients with Type 2 Diabetes Mellitus , 2011, Postgraduate medicine.

[30]  N. Marchionni,et al.  Effect of metformin on cardiovascular events and mortality: a meta‐analysis of randomized clinical trials , 2011, Diabetes, obesity & metabolism.

[31]  J. Lindh,et al.  Metformin for weight reduction in non-diabetic patients on antipsychotic drugs: a systematic review and meta-analysis , 2011, Journal of psychopharmacology.

[32]  Del D. Miller,et al.  Systematic Review and Meta-analysis of Pharmacological Interventions for Weight Gain from Antipsychotics and Mood Stabilizers. , 2012, Current psychiatry reviews.

[33]  G. Bray,et al.  Long-Term Safety, Tolerability, and Weight Loss Associated With Metformin in the Diabetes Prevention Program Outcomes Study , 2012, Diabetes Care.

[34]  Ping Zhang,et al.  The 10-Year Cost-Effectiveness of Lifestyle Intervention or Metformin for Diabetes Prevention , 2012, Diabetes Care.

[35]  B. Schehler,et al.  Effectiveness of Metformin on Weight Loss in Non-Diabetic Individuals with Obesity , 2012, Experimental and Clinical Endocrinology & Diabetes (Barth).

[36]  Morton B. Brown,et al.  The 10-year cost-effectiveness of lifestyle intervention or metformin for diabetes prevention: An intent-to-treat analysis of the DPP/DPPOS , 2013 .

[37]  J. Lieberman,et al.  Metformin for weight loss and metabolic control in overweight outpatients with schizophrenia and schizoaffective disorder. , 2013, The American journal of psychiatry.

[38]  J. McGill,et al.  American Association of Clinical Endocrinologists' comprehensive diabetes management algorithm 2013 consensus statement--executive summary. , 2013, Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists.

[39]  B. Braun,et al.  Metformin modifies the exercise training effects on risk factors for cardiovascular disease in impaired glucose tolerant adults , 2012, Obesity.

[40]  L. Rojas,et al.  Metformin: an old but still the best treatment for type 2 diabetes , 2013, Diabetology & Metabolic Syndrome.

[41]  Overweight in polycystic ovary syndrome. An update on evidence based advice on diet, exercise and metformin use for weight loss. , 2013, Minerva endocrinologica.

[42]  M. Murad,et al.  Diagnosis and Treatment of Polycystic Ovary Syndrome: An Endocrine Society Clinical Practice Guideline , 2013, The Journal of clinical endocrinology and metabolism.

[43]  S. Lai,et al.  Effects of Metformin Versus Glipizide on Cardiovascular Outcomes in Patients With Type 2 Diabetes and Coronary Artery Disease , 2013, Diabetes Care.

[44]  H. Gerstein,et al.  Determinants of Weight Gain in the Action to Control Cardiovascular Risk in Diabetes Trial , 2013, Diabetes Care.

[45]  Silvio E. Inzucchi,et al.  Metformin in patients with type 2 diabetes and kidney disease: a systematic review. , 2014, JAMA.

[46]  S. Kashyap,et al.  Effects of metformin on weight loss: potential mechanisms , 2014, Current opinion in endocrinology, diabetes, and obesity.

[47]  K. Flegal,et al.  Prevalence of Childhood and Adult Obesity in the United States, 2011–2012 , 2014 .

[48]  S. McGuire,et al.  Centers for Disease Control and Prevention. State indicator report on Physical Activity, 2014. Atlanta, GA: U.S. Department of Health and Human Services; 2014. , 2014, Advances in nutrition.

[49]  A. Hermann,et al.  Body composition is improved during 12 months' treatment with metformin alone or combined with oral contraceptives compared with treatment with oral contraceptives in polycystic ovary syndrome. , 2014, The Journal of clinical endocrinology and metabolism.

[50]  Muhammad Usman Ali,et al.  Treatment for overweight and obesity in adult populations: a systematic review and meta-analysis. , 2014, CMAJ open.

[51]  C. Welt,et al.  Metformin improves glucose effectiveness, not insulin sensitivity: predicting treatment response in women with polycystic ovary syndrome in an open-label, interventional study. , 2014, The Journal of clinical endocrinology and metabolism.

[52]  N. Ruderman,et al.  AMPK activation: a therapeutic target for type 2 diabetes? , 2014, Diabetes, metabolic syndrome and obesity : targets and therapy.

[53]  C. Mangione,et al.  Metformin Prescription for Insured Adults With Prediabetes From 2010 to 2012 , 2015, Annals of Internal Medicine.

[54]  F. Huang,et al.  Metformin promotes irisin release from murine skeletal muscle independently of AMP‐activated protein kinase activation , 2015, Acta physiologica.

[55]  C. Apovian,et al.  Pharmacological management of obesity: an endocrine Society clinical practice guideline. , 2015, The Journal of clinical endocrinology and metabolism.

[56]  S. Hennessy,et al.  Metformin use reduction in mild to moderate renal impairment: possible inappropriate curbing of use based on food and drug administration contraindications. , 2015, JAMA internal medicine.

[57]  Bingshu E. Chen,et al.  Effect of metformin vs placebo on and metabolic factors in NCIC CTG MA.32. , 2015, Journal of the National Cancer Institute.

[58]  U. Hostalek,et al.  Therapeutic Use of Metformin in Prediabetes and Diabetes Prevention , 2015, Drugs.

[59]  M. Agius,et al.  A review of the evidence for the use of metformin in the treatment of metabolic syndrome caused by antipsychotics. , 2015, Psychiatria Danubina.

[60]  V. Montori,et al.  Clinical review: Drugs commonly associated with weight change: a systematic review and meta-analysis. , 2015, The Journal of clinical endocrinology and metabolism.