It’s just amazing how all round beneficial pharmaceutical drugs can be — even better than nature itself. Take Metformin, for example — the oral anti-diabetic drug. Metformin gets sold under trade names like Glucophage XR, Riomet, Fortamet, Glumetza, Obimet, Dianben, Diabex, and Diaformin. It’s the first-choice drug for Type-2 diabetes, particularly for overweight patients. Studies have shown that compared to insulin, Metformin yields a 30 percent improvement in preventing complications of diabetes and mortality.
Over the years since its approval by the FDA in 1994, Metformin has been tested for various other applications. Foremost among these has been as a weight-reducing remedy. Basically, Metformin works by increasing insulin sensitivity, which leads to a decrease in appetite. Now, a new study hot off the press shows that Metformin helps obese teens lose weight when combined with exercise and a healthy diet. The study, led by Darrell Wilson, MD, of Stanford University, followed 78 teens aged 13-17 for two years. The subjects all fell within the 95th percentile weight-wise. None of the subjects had diabetes.
After almost a year (48 weeks), the teens taking Metformin and following a healthy regimen had a 0.9-point drop in body mass index, compared with only a 0.2-point gain in the control group. Although this sounds impressive, keep in mind that a 0.9 loss equates to about a six or seven pound weight reduction in an average-height teen. While “statistically” significant, it’s hardly overwhelming given how fat these kids started out, and considering that they dieted for almost a year to achieve that less than exciting loss. Without the drug, they lost a pound or two, but with it, only a handful more — hardly enough weight loss to carry them over to the realm of svelte and healthy.
“It’s not a 20-pound weight loss, it’s not what the world is looking for in a weight-loss drug. It was a meaningful weight loss, just not a spectacular one,” said Dr. Wilson. Plus, although the weight loss remained for three to six months after the subjects discontinued the drug, after that, their weight trended upward again to match the weight of the control subjects. Plus, the drug only impacted body mass index, with no impact at all on fat distribution, abdominal fat, or insulin resistance.
In spite of these limitations, researchers expressed enthusiasm that Metformin may just be the next best thing in the lineup of potential miracle drugs to make fat go away. “These results indicate that metformin may have an important role in the treatment of adolescent obesity,” they wrote. From a personal point of view, I’d have to say that any researchers who call a temporary weight-loss of six to seven pounds over a year “important” pretty much have nullified the value of their opinion out of the gate.
Certainly the obesity epidemic among kids and teens is frightening and worrisome, because obesity leads to disease and greater chance of early death. And certainly the lure of a pill that can put an end to it is almost irresistible. But is Metformin that drug? Should it be given to kids for the express purpose of temporarily losing a small amount of weight? And what effects does it have, beyond shaving off a few pounds?
First, though Metformin is a relatively benign pharmaceutical, it does have side effects. During the course of the study, 31 percent more of the subjects taking Metformin experienced headaches, 23 percent nausea, and 15 percent vomiting (that’s five times the amount experienced by the control group). After discontinuing the drug, the Metformin subjects experienced more headaches than the controls. Several had “adverse events” of a serious nature, but they “were considered unrelated to the Metformin, including a case of leg vein thrombosis, and one discontinued the study because of nausea. Other potential side effects include feeling tired or weak, muscle pain, trouble breathing, stomach pain, feeling cold, dizziness or lightheadedness, and a slow or irregular heartbeat, chest pain, allergic reactions, and symptoms of low or high blood sugar, including dizziness, confusion, seizures, and so on. Plus, though rare, Metformin can cause lactic acidosis, a potentially deadly condition, and heart failure.
And don’t forget, the benefits gained in this study came only to subjects combining Metformin with lifestyle changes, including regulating diet and exercising. A study last year found that those who exercised 30 minutes five times a week plus stuck to a low-fat diet reduced diabetes incidence by 34 percent over a 10-year period compared to a control group that implemented no changes. Those who took Metformin instead of trying lifestyle modifications reduced incidence by only 18 percent.
As I’ve written before, modifying diet and exercising gets the body in shape and keeps it working well, whereas diabetes drugs do nothing to improve the natural functioning of the body. It’s the same old story all over again. There’s no substitute for eating well and exercising. Adding Metformin into the mix may temporarily shave off a few pounds over the course of a year, but at a cost. Those costs include side effects and potential dangers as well as the price-tag for diabetes medications, which can cost $200 or more per 60 pills.