You’ve tried every diet, signed up for multiple workout programs, and even experimented with supplements that claim to boost metabolism. But despite your efforts, the scale barely moves, and when it does, the weight creeps back. Losing weight can be frustrating, especially when your body fights your every effort to lose weight. For non-diabetics struggling with weight loss, the challenge often lies in hidden metabolic factors.

At Genesis Lifestyle Medicine, we understand that weight loss is more than just “calories in, calories out.” If you’ve been struggling to lose weight despite making healthy lifestyle choices, you may have heard about Metformin as a potential option. While originally formulated to help people with type 2 diabetes manage blood sugar, Metformin has gained attention for its off-label use in weight loss. But how does it work, and is it the right option for you?

Let’s explore the science behind Metformin and its potential benefits for weight loss.

How metformin works for weight loss

Metformin works by altering the way your body processes glucose. While it doesn’t directly cause weight loss, its effects on insulin, appetite, and metabolism can contribute to gradual and sustainable weight reduction. Here’s how it helps:

• Improves insulin sensitivity: Many people struggle with weight loss because of insulin resistance. When your body doesn’t use insulin efficiently, excess glucose gets stored as fat. Metformin helps your body use insulin more effectively, preventing unnecessary fat storage.
  
• Reduces glucose production in the liver: Your liver produces glucose even when you’re not eating. Metformin reduces the production of glucose in the liver, which lowers blood sugar levels and can contribute to weight loss.
  
• Decreases appetite: Studies suggest that Metformin can help control hunger by affecting appetite-regulating hormones like GLP-1. This means you may naturally eat less without feeling deprived, facilitating sustainable weight loss over time.
  
• Changes gut microbiome: Your gut bacteria play a role in weight loss. Metformin alters the gut microbiome, which can improve digestion, reduce inflammation, and support weight loss.

While these mechanisms are promising, Metformin isn’t a magic pill for weight loss. It works best when combined with a healthy diet and regular exercise.

Who can benefit from metformin for weight loss?

Metformin is not a first-line treatment for weight loss, but certain individuals may benefit from it. If you are struggling to lose weight despite lifestyle changes, your doctor may consider prescribing Metformin in the following situations:

• Individuals with insulin resistance: If you experience difficulty losing weight, fatigue after eating, or sugar cravings, you may have insulin resistance, a condition where your cells don’t respond effectively to insulin. Metformin can help improve insulin sensitivity, making it easier for your body to regulate blood sugar and burn fat.
  
• People with obesity: Doctors often define obesity as having a body mass index (BMI) of 30 or higher. If you have obesity but don’t have diabetes, Metformin may help you shed excess weight and reduce your risk of metabolic disorders.
  
• Those on medications that cause weight gain: Certain antipsychotic and steroid medications can contribute to weight gain by affecting metabolism and increasing appetite. In some cases, Metformin is prescribed to counteract these effects.
  
• Women with PCOS (polycystic ovary syndrome): PCOS is a hormonal disorder that affects millions of women and is often linked to weight gain, insulin resistance, and difficulty losing weight. Metformin can restore ovulation, reduce androgen levels, and support weight loss.

How much weight can you lose with metformin?

Metformin doesn’t lead to dramatic weight loss like medications such as semaglutide (Wegovy, Ozempic) or tirzepatide (Zepbound, Mounjaro), but research suggests it can help with modest and steady weight loss over time.

• In a large study, participants lost an average of 5.5 pounds over one year.
• About one-third of those who took Metformin lost at least 5% of their body weight after a year.
• Those who took it for up to 15 years saw an average weight loss of 6.2% of their body weight.

Metformin dosage for weight loss

Since Metformin is not FDA-approved for weight loss, there’s no standard dosage specifically for non-diabetic weight loss. However, studies and clinical experience suggest that weight loss benefits are seen at doses between 1,500 mg and 2,500 mg per day. Doctors typically start patients on a low dose (500 mg daily) and gradually increase it to minimize side effects. Extended-release (XR) formulations are often preferred because they reduce side effects.

Side effects and considerations

Metformin is generally safe and well-tolerated, but it does have some side effects, including:

• Gastrointestinal issues (nausea, diarrhea, bloating) – these usually improve after a few weeks.
• Vitamin B12 deficiency – long-term use can reduce B12 levels, so supplementation may be necessary.
• Lactic acidosis – a rare but serious condition that occurs mostly in people with kidney or liver disease.

You should not take Metformin if you have advanced kidney disease, severe heart failure, or drink excessive alcohol. Always consult with a healthcare provider before starting Metformin.

Combining metformin with lifestyle changes

For the best results, Metformin should be combined with a balanced diet and regular physical activity. Here’s how you can maximize weight loss while taking Metformin:

• Follow a low-glycemic diet: Focus on lean proteins, healthy fats, and fiber-rich carbohydrates to prevent blood sugar spikes.
  
• Exercise regularly: Aim for 150 minutes of moderate-intensity exercise per week, such as walking, cycling, or strength training.
  
• Stay hydrated: Drinking water helps flush out excess glucose and supports metabolism.
  
• Monitor your progress: Keep track of your weight, energy levels, and hunger cues to see how your body responds.

If you’re struggling with stubborn weight despite making healthy changes, Metformin may be a helpful tool for weight loss. While it’s not a substitute for proper nutrition and exercise, it can improve insulin sensitivity, reduce appetite, and promote gradual weight loss in non-diabetics. At Genesis Lifestyle Medicine, we take a personalized approach to weight management, offering medical weight loss solutions that fit your unique needs—schedule a consultation with our expert team to explore your weight loss options today.