Gaining weight on metformin
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Gaining Weight on Metformin: Insights from Recent Research
Metformin and Weight Management in Antipsychotic-Induced Weight Gain
Metformin's Role in Preventing Weight Gain with Antipsychotics
Several studies have investigated the efficacy of metformin in managing weight gain associated with antipsychotic medications. A multicentric, double-blind, placebo-controlled trial demonstrated that metformin could prevent or reverse weight gain in patients taking olanzapine, a common antipsychotic. Patients in the metformin group lost an average of 1.4 kg over 12 weeks, while those in the placebo group maintained their weight. Another study focusing on children and adolescents found that metformin stabilized weight in subjects who had gained more than 10% of their body weight due to antipsychotic therapy, whereas the placebo group continued to gain weight. Additionally, a study on drug-naive first-episode schizophrenia patients showed that metformin effectively attenuated olanzapine-induced weight gain and insulin resistance.
Long-Term Effects and Mechanisms
The long-term effects of metformin on weight management were explored in a 4.3-year trial involving type 2 diabetic patients. The study found that metformin prevented significant weight gain compared to placebo, although the mechanism was not attributed to decreased energy intake. This suggests that metformin's weight-sparing effects might involve other metabolic pathways.
Metformin in Pregnancy and Weight Management
Effects on Gestational Weight Gain
Research has also examined the impact of metformin on weight management in pregnant women who are overweight or obese. A randomized, double-blind, placebo-controlled trial found that metformin, in addition to dietary and lifestyle advice, resulted in lower average weekly gestational weight gain compared to placebo. Another study confirmed that metformin reduced maternal weight gain but did not significantly affect neonatal birth weight. However, the overall impact on pregnancy and birth outcomes was minimal, indicating that while metformin can help manage weight, it may not significantly improve other pregnancy-related health metrics.
Metformin and Weight Gain in Autism Spectrum Disorder
Genetic Factors Influencing Metformin Response
In children and adolescents with autism spectrum disorder (ASD) who experienced weight gain due to atypical antipsychotics, metformin was found to attenuate this weight gain. A study investigating the pharmacogenetics of metformin revealed that genetic variations in specific genes (ATM and OCT1) could predict the response to metformin in reducing body mass index z-scores. This highlights the potential for personalized medicine approaches in managing medication-induced weight gain.
Conclusion
Metformin has shown promise in managing weight gain associated with antipsychotic medications and in pregnant women who are overweight or obese. While it effectively stabilizes or reduces weight in these populations, the mechanisms behind its effects are not fully understood and may involve complex metabolic pathways. Additionally, genetic factors may influence individual responses to metformin, suggesting a potential for personalized treatment strategies. Overall, metformin remains a valuable tool in the management of weight gain, particularly in specific clinical scenarios.
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