A 'miracle drug' used for diabetes prevention could also be a key to weight loss maintenance

Metformin is often referred to as a "miracle cure".
Sarah Schmalbruch / INSIDER
Metformin has been called a "panacea" because of its low cost, minimal risk, and ability to fight diabetes and potential aging.
An April 2019 study found that metformin can help some people lose weight and maintain that weight loss for long periods of time. Researchers say the inexpensive diabetes drug is an unlikely solution to many age-related health problems.
There is also early evidence that the drug could prevent fatal coronavirus complications in some women.
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Researchers now have more clues as to why metformin, a low-cost diabetes drug that has been called a "miracle" because of its potential anti-aging properties, can help reduce weight. There is also early evidence that the drug could help reduce COVID-19-related deaths in women with diabetes and obesity.
A study published in Annals of Internal Medicine in April 2019 found that metformin can help people lose weight in the long term.
Researchers believe that the drug - which is prescribed for pre-diabetics, diabetics and off-label patients with PCOS - can also help patients who have lost a lot of weight to keep it off in the long term.
The study compared the effects of metformin compared to diet and exercise on weight loss and weight loss.
In a randomized controlled trial, researchers prescribed over 3,000 overweight, overweight, or elevated glucose levels to placebo, metformin, or intensive lifestyle intervention (ILS), which consisted of a regulated diet and exercise plan. The researchers then observed participants over 15 years of age and how much weight they had lost in the first year of the study and how well they could maintain this weight loss over a longer period of time.
The researchers defined long-term weight loss as a weight loss of at least 5% of the person's basis weight in their one-year study.
They found that participants using the ILS method were more likely to lose at least 5% of their weight in the first year than metformin users, while metformin users lost an average of 2.1% of their weight over a two-year period.
Despite their lower overall weight loss rates, people who took 850 mg metformin twice a day were more likely to experience weight loss over time than people who had lost weight using the ILS method.
"People [who do ILS] showed no enthusiasm for participating in these lifestyle intervention sessions. The enthusiasm for diet and exercise generally does not last long," said Dr. Kishore M. Gadde, the lead study author, told INSIDER. "Taking one pill a day is much easier than dieting and exercising for 15 years. Almost no one can do it."
Metformin was not helpful for everyone, but it did help some maintain weight loss
Gadde noted that the people who lost at least 5% weight and maintained this weight loss when using metformin were a relatively small group - only 28.5% of the study participants - so the drug, despite its effectiveness for some, was not for everyone The process offered involved advantages.
However, Gadde believes more research should be done on the potential use of metformin as a weight loss tool, as 28.5% have been able to maintain about 2% weight loss over an average of 10 years.
Metformin helped 28.5% of the study participants lose at least 5% body weight and maintain a weight loss of 2% for long periods.
"Maybe people who need to lose weight for health reasons can lose weight on a reduced-calorie diet over a period of 3 months and then go to a family doctor and get something like metformin to see if they can maintain this weight loss. That would be a practical use for it, "said Gadde.
The study had some limitations. Not all participants appeared for their annual check-ups, which left some gaps in the data. Gadde also said that some of the patients could take higher doses of metformin than that prescribed in the study, as the researchers ultimately left it up to the participants' individual healthcare providers.
"[Some] people in the study had pre-diabetes and some eventually developed diabetes. Because metformin is a diabetes medication, they may have taken additional metformin," he said.
However, Metformin's cost efficiency makes it an attractive option. For example, a 30-day supply of 1,000 mg metformin tablets at Walmart costs $ 4, compared to the thousands of dollars that other obesity drugs cost each year.
"The sheer consistency of [metformin for weight control] surprised me. This needs to be followed up," said Gadde.
Metformin can also have life-extending properties
According to new research by the Salk Institute, metformin can switch certain cell processes on and off, including one that affects metabolism and plays a role in the aging of a person. In this way, metformin could slow aging and potentially extend a person's lifespan, the researchers wrote.
Before this study, the researchers knew only one cell pathway affected by metformin, so the results open up new research opportunities with the drug.
"The big questions now are what goals metformin can bring to everyone's health, not just type 2 diabetics," said Reuben Shaw, co-correspondent for the paper and director of the cancer center named by Salks NCI, in a press Release.
There is early evidence that the drug can prevent deaths related to COVID-19 in some people
Most recently, University of Minnesota researchers have completed one of the largest studies on COVID-19 risk factors, the Minnesota Star Tribune reported.
They found that diabetes and obesity were risk factors for COVID 19-related death, but observed that metformin helped reduce the risk of women dying from the virus by up to 24%. The women, who were all diabetic, took metformin to control their blood sugar levels.
The lead study author Dr. Christopher Tignanelli told the Star Tribune that people should not look for metformin as a viral cure, but that his team's results open up new avenues for non-vaccinable solutions to infectious diseases like coronavirus.
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