Metformin and Weight Loss?

[NoraPanda]

Hi all. New to the forum and diagnosed T2 3 months ago. HbA1c of 7%. It was a shock as don’t show any of the typical symptoms of T2 (I’m not overweight and I keep fit: only went to the doctor as feeling very tired). I was on Metformin 500mg for the first 3 weeks and now been on 1000mg for 2 months. Will go for next blood test next week. Home blood sugars testing have been slightly reduced. The issue is that I have lost half a stone in less than 2 months: from 9 to 8.5 stone. I’m female and 5 foot 4. I am eating less carbs, but not cut them out. Nothing else has changed other than the Metformin. Would appreciate your thoughts. Do others have weight loss on Metformin? And will it plateau out, as I don’t want to lose any more weight? Thanks.

 

[Dr Snoddy]

Hi Norapanda. Have you replaced the reduced carbohydrate in your diet with extra protein and healthy fat?

 

[Daibell]

Hi. Be aware that Metformin started life as an appetite suppressant but It's only mild in it's action. Do increase your Proteins and Fats to try to increase your weight if needed

 

[CatrinJ]

I had an endocrinology appointment last week (I'm trans) and my type 2 diagnosis was discussed along with my weight loss regime (almost 10kg so far.) I was asked if I was open to taking metformin as that would apparently help me with my weight loss. I said I was hoping to avoid starting on meds if at all possible because meds plus intermittent fasting would make hypos more likely. She said I couldn't get hypos with metformin and it would be prescribed for weight loss and not for the diabetes.

I don't really understand how metformin is supposed to work for weight loss. I gather it inhibits the liver from producing glucose but if I want to burn fat then surely I need the liver to break fat down into glucose? Isn't that the purpose of keto diets?

In the short term, sounds like a daily portion of nuts would be a quick and easy way to give you the low-carb but nutritious calories you need to maintain your bodyweight.

 

[NoraPanda]

Hi Norapanda. Have you replaced the reduced carbohydrate in your diet with extra protein and healthy fat?

I’ve been a vegetarian for 30 years so seeds, nuts etc. have always played a part. But maybe I need to look into it further. I don’t mind being 8.5 stone, but don’t want the weight loss to continue. Thanks.

 

[NoraPanda]

I had an endocrinology appointment last week (I'm trans) and my type 2 diagnosis was discussed along with my weight loss regime (almost 10kg so far.) I was asked if I was open to taking metformin as that would apparently help me with my weight loss. I said I was hoping to avoid starting on meds if at all possible because meds plus intermittent fasting would make hypos more likely. She said I couldn't get hypos with metformin and it would be prescribed for weight loss and not for the diabetes.

I don't really understand how metformin is supposed to work for weight loss. I gather it inhibits the liver from producing glucose but if I want to burn fat then surely I need the liver to break fat down into glucose? Isn't that the purpose of keto diets?

In the short term, sounds like a daily portion of nuts would be a quick and easy way to give you the low-carb but nutritious calories you need to maintain your bodyweight.

Thanks. Hope all goes well for you. Think I need to increase the nut intake!

 

[NoraPanda]

Hi. Be aware that Metformin started life as an appetite suppressant but It's only mild in it's action. Do increase your Proteins and Fats to try to increase your weight if needed

I didn’t realise that about it. Thanks. Will do.

 

[bulkbiker]

if I want to burn fat then surely I need the liver to break fat down into glucose? Isn't that the purpose of keto diets?

Not quite... you want to switch from burning glucose for energy to burning fat which is what a ketogenic diet will do for you.
The process can take a while as you have to burn through most of your stored glucose reserves before you can hit fat burning mode.
However it's a great strategy for dealing with T2 elevated blood sugars and can often lead to weight loss (for some of us loads).

 

[AloeSvea]

Yeah, metformin does have a weight loss aspect to it, at least for some, and they are not entirely sure how, but presumably has an effect on the digestive processes/hormones/enzymes. And anyone who has had 'digestive processes' side effects with metformin is probably not at all surprised! Some kind of medication effect, and the effect of nausea and gut pains and so on are indistinguishable at the end of the day, and indeed - cannot be separated for some people!

I agree with others above - if you are a rare type two and wanting to stall weight loss rather than otherwise, then healthy fats are the way to go. (I think it is very hard to overdo protein, as it is so filling, and goes to body maintenance directly, and I have not read anything about weight gain or stalling on protein - it's usually alcohol, carbs, fats, in that order....)

With regards to your personal fat threshold, @NoraPanda, as in body fat and being able to reverse/go into remission with the type two - Prof Taylor and co. suggest that the non-diabetic profile is along the lines of the weight and lean bod you probably had in high school. I will never be that lean and muscular again, but maybe that is cool for you? Worth giving it a go?

 

[Dr Snoddy]

I’ve been a vegetarian for 30 years so seeds, nuts etc. have always played a part. But maybe I need to look into it further. I don’t mind being 8.5 stone, but don’t want the weight loss to continue. Thanks.

Healthy fats could also include cold pressed olive or rapeseed oil, avocado, butter, cheese, specialist oils like avocado and walnut. Depends where you are on the vegetarian/vegan spectrum! Some forumites certainly put butter on all of their vege or grate extra cheese on to dishes.

 

[Daibell]

I had an endocrinology appointment last week (I'm trans) and my type 2 diagnosis was discussed along with my weight loss regime (almost 10kg so far.) I was asked if I was open to taking metformin as that would apparently help me with my weight loss. I said I was hoping to avoid starting on meds if at all possible because meds plus intermittent fasting would make hypos more likely. She said I couldn't get hypos with metformin and it would be prescribed for weight loss and not for the diabetes.

I don't really understand how metformin is supposed to work for weight loss. I gather it inhibits the liver from producing glucose but if I want to burn fat then surely I need the liver to break fat down into glucose? Isn't that the purpose of keto diets?

In the short term, sounds like a daily portion of nuts would be a quick and easy way to give you the low-carb but nutritious calories you need to maintain your bodyweight.

Hi. I think you will find that the body metabolises fat via the bowel system and not directly via the liver i.e. a very different route than Carbs. It's one reason why it's the Carbs rather than Fats which contribute to weight gain. Keto diets train the body to do fat conversion but the body prefers to use carbs when it can?

 

[valann]

Hi all. New to the forum and diagnosed T2 3 months ago. HbA1c of 7%. It was a shock as don’t show any of the typical symptoms of T2 (I’m not overweight and I keep fit: only went to the doctor as feeling very tired). I was on Metformin 500mg for the first 3 weeks and now been on 1000mg for 2 months. Will go for next blood test next week. Home blood sugars testing have been slightly reduced. The issue is that I have lost half a stone in less than 2 months: from 9 to 8.5 stone. I’m female and 5 foot 4. I am eating less carbs, but not cut them out. Nothing else has changed other than the Metformin. Would appreciate your thoughts. Do others have weight loss on Metformin? And will it plateau out, as I don’t want to lose any more weight? Thanks.

Hi NoraPanda, Just wanted to say welcome to the forum.

I am not on metformin so can't help with the above, but there are very knowledgeable, friendly people here that as you have seen are always happy to help and support.

 

[Dr Snoddy]

Hi. I think you will find that the body metabolises fat via the bowel system and not directly via the liver i.e. a very different route than Carbs. It's one reason why it's the Carbs rather than Fats which contribute to weight gain. Keto diets train the body to do fat conversion but the body prefers to use carbs when it can?

Hi, could you please explain or give a link to how fat is metabolized via the bowel system?

 

[Daibell]

Hi, could you please explain or give a link to how fat is metabolized via the bowel system?

Hi. There are several links but most are not very clear. This one indicates that the process is complex but perhaps makes the point:
https://www.medicalnewstoday.com/articles/fat-digestion#fat-digestion. I should really have said the small intestine rather than bowel system.

 

[Dr Snoddy]

Thanks Diabell. Perhaps you were referring to how and where fat is digested rather than metabolised.

 

[Dr Snoddy]

Sorry I managed to upload this image twice! I think this shows that glucose is the preferred energy source in cells and that fatty acids, one of the two breakdown products of fats, require extra processing before their energy can be released. However, once this pathway begins to be used, fats are an effective energy source and can replace carbohydrate (glucose)

 

[AloeSvea]

Love those diagrams!