Can metformin help you lose weight? Explore the research on how this common diabetes drug can affect weight loss, including improved blood sugar control, reduced hunger, and healthier lifestyle habits.

How Metformin Works

Metformin is one of the most commonly prescribed diabetes drugs in the United States, with over 85 million prescriptions currently in use. This medication works by lowering the amount of glucose released from the liver and helping the body’s existing insulin work more effectively, thus reducing blood sugar levels. As a result, the risk of diabetes complications such as heart disease, stroke, neuropathy, and retinopathy can substantially decrease.

Does Metformin Cause Weight Loss?

While not technically classified as a weight-loss drug, research has found a strong link between taking metformin and weight loss. A longitudinal study published in the journal Diabetes Care concluded that metformin can be successfully used to lose excess body weight. Here’s how metformin can help with weight loss:

Better Blood Sugar Control

By improving insulin sensitivity and regulating blood sugar levels, metformin can lead to modest reductions in body weight, especially for those with type 2 diabetes whose bodies are not appropriately releasing insulin and controlling blood sugar. When insulin resistance goes down, weight often does too. However, in a small proportion of the population with previously undiagnosed type 2 diabetes and extremely high HbA1c levels, a modest weight gain may be seen initially, particularly if they were in diabetic ketoacidosis (DKA) at diagnosis. This is a rare occurrence, as most people with type 2 diabetes at diagnosis are still producing insulin and have only slightly elevated HbA1c levels.

Reduced Hunger Cues

Metformin has been shown to reduce hunger, both before and after meals, by lowering the amount of insulin in the blood and reducing blood sugar spikes that can trigger hunger. In one study, women with type 2 diabetes who were taking the highest dose of metformin (1,700 mg, three times per day) reported significantly less hunger than those in the placebo and lower-dose groups. This can lead to a reduction in calorie intake and subsequent weight loss.

Healthier Lifestyle Habits

Many people may lose weight while taking metformin if they also incorporate dietary changes and increase their physical activity. Starting a metformin regimen without any lifestyle changes will most likely only lead to a modest drop in weight. Strategies to accelerate weight loss while on metformin include:

• Exercising for 30 or more minutes per day, most days of the week
• Incorporating resistance training 2-3 times per week
• Switching from sugar-sweetened beverages to water or other no-calorie drinks
• Increasing protein intake and reducing added sugar and refined carbohydrates
• Eating plenty of healthy fruits and vegetables
• Increasing fiber intake

It’s important to work closely with your doctor to create an eating and activity plan that aligns with your individual needs and lifestyle.

Gastrointestinal Upset

While not the most pleasant side effect, the gastrointestinal upset that can sometimes occur with metformin, including nausea, vomiting, and diarrhea, can also contribute to weight loss in some cases.

How Much Weight Can You Lose on Metformin?

The amount of weight loss experienced while taking metformin can vary greatly from person to person. Studies have shown that individuals with type 2 diabetes who take metformin can lose an average of 5-10% of their starting body weight over the course of 6-12 months, with some losing even more. However, the actual weight loss will depend on factors such as starting weight, adherence to lifestyle changes, and overall health status. It’s important to work closely with your healthcare provider to set realistic weight loss goals and monitor your progress.

Is Metformin a Magic Bullet for Weight Loss?

No, metformin is not a magic bullet for weight loss. While it can contribute to weight loss in several ways, it is not a standalone solution. Metformin works best when combined with a healthy diet and regular exercise. The weight loss benefits of metformin are often modest, and the medication alone is unlikely to result in dramatic or rapid weight loss. It’s important to have realistic expectations and to work closely with your healthcare provider to develop a comprehensive weight management plan.

Conclusion

In summary, while metformin is not primarily a weight-loss drug, research has shown that it can contribute to weight loss in several ways, including improved blood sugar control, reduced hunger cues, and the promotion of healthier lifestyle habits. However, metformin is not a magic bullet for weight loss, and it works best when combined with a healthy diet and regular physical activity. If you are taking metformin and are looking to lose weight, it’s important to work closely with your healthcare provider to develop a comprehensive plan that meets your individual needs and goals.

Metformin and Weight Loss: Can a Pill Help You Lose Weight?

Metformin is one of the most commonly prescribed diabetes drugs in the United States, with over 85 million prescriptions currently in use. 

People usually take metformin if they have type 2 diabetes and are struggling with insulin resistance (decreased sensitivity to insulin) and higher-than-normal blood sugars. 

Metformin may cause a lot of side effects, but one of the most common questions about the drug is if it causes weight loss. 

Let’s take a look at what the research says about metformin and weight loss.

Table of Contents

How metformin works

Metformin works by lowering the amount of glucose released from the liver, and by helping existing insulin produced by the body work better, thus lowering blood sugar levels. 

As your body is better able to metabolize glucose, your risk of diabetes complications such as heart disease, stroke, neuropathy, and even retinopathy substantially decrease.  

Does metformin cause weight loss? 
While not technically classified as a weight-loss drug, researchers have found a strong link between taking metformin and weight loss. 
A longitudinal study published in the journal Diabetes Care concluded that metformin can be successfully taken to lose excess body weight. 
Metformin can help you lose weight for several reasons:
Better blood sugar control
Since metformin is proven to improve insulin sensitivity and thus blood sugar control, people with type 2 diabetes whose bodies are not appropriately releasing insulin and regulating their blood sugars (i.e. have higher blood sugar levels despite also having excess insulin in their bloodstream), may see modest reductions in body weight. 
This is mostly due to the fact that the body will stop over-releasing insulin into the bloodstream, and their bodies will start to metabolize glucose appropriately. When insulin resistance goes down, weight often does, too.
However, in a very small proportion of the population (mainly people with previously undiagnosed type 2 diabetes whose hba1c levels were extremely high), people may see a modest gaining of weight initially, especially if they were in diabetic ketoacidosis (DKA) at diagnosis. 
This is a very rare occurrence because most people with type 2 diabetes at diagnosis are still producing insulin and their hba1c is only slightly elevated. Furthermore, most people with type 2 diabetes are not in DKA at diagnosis; their bodies are still producing insulin to keep them out of DKA, but they’re just resistant to the insulin that’s being released by their pancreas. 
 
Reduced hunger cues 
One documented side effect of the drug is reduced hunger, which usually results from lower amounts of insulin in the blood and fewer blood sugar spikes that can send not only your blood sugar, but also your hunger, soaring. 
Metformin also helps eliminate hunger cues. In one study of women that had type 2 diabetes (but were not on insulin), researchers found that of three groups (one group had a placebo pill, and the other two groups had varying amounts of metformin), the group on the highest amount of metformin (1,700 mg, three times per day), had significantly less hunger both before and after meals than the other two groups. 
That group was also more likely to eat less than the other two groups as well. 
Even just eating a few hundred fewer calories per day can cause moderate, noticeable, weight loss over time. Eating 200 fewer calories per day for only 18 days can cause you to lose 1 pound of body fat (which is equal to 3,500 calories). 
Eating 200 fewer calories per day for an entire year can cause you to lose over 20 lbs! Small, subtle changes can make a big difference. 
Related: How to Find Your Daily Calorie Need.
 
Healthier lifestyle habits 
Many people may lose weight while taking metformin if they are also incorporating dietary changes and increasing their physical activity at the same time.  
Starting a metformin regimen without any lifestyle changes will most likely only lead to a modest drop in weight. 
The following strategies will help accelerate your weight loss if you’ve just started on a metformin regimen: 
Exercise for 30 or more minutes per day, most days of the week
Incorporate resistance training 2-3 times per week 
Switch from all sugar-sweetened beverages to water or other no-calorie drinks
Increase your protein intake and lower your added-sugar and refined carbohydrate intake 
Eat plenty of healthy fruits and vegetables
Increase your fiber intake 
Work with your doctor when creating an eating and activity plan that will work for you and your lifestyle. 
 
Gastrointestinal upset 
While not the most pleasant side effect, having an upset stomach with the accompanying nausea, vomiting, and diarrhea that can sometimes occur, can also contribute to weight loss in patients taking metformin, especially when first beginning treatment.  
According to a study published in the Journal of Research in Pharmacy Practice, gastrointestinal upset is the chief complaint amongst patients when starting metformin treatment in their original, tablet formation. 
GI side effects can affect up to 63% of people who take metformin! Bloating, nausea, and diarrhea can be so troubling that you may shirk eating meals, and subsequently eat fewer calories, resulting in weight loss. 
If at any point you feel that your weight loss is dangerous (having trouble keeping your blood sugars stable or out of a dangerously low range) or you’re becoming dehydrated, contact your doctor immediately or seek emergency medical help. 
Read more: Metformin Side Effects: What You Need to Know.
 
What is the correct dosage to experience weight loss? 
According to the Mayo Clinic, patients taking oral extended-release tablets usually start between 500-1000 mg taken per day, and work their way up to 2,500 mg per day (not to exceed that amount).  
If you are taking metformin for weight loss, work with your doctor to determine the appropriate starting dose for you. 
Do NOT increase your dose without your doctor’s guidance, as you may experience severe side effects, such as nausea, vomiting, diarrhea, bloating, and muscle weakness. 
Read more: Metformin Dosage Guide 
What is the average weight loss with metformin?
The typical weight loss after one year of metformin use is only between 4-7 lbs. Many people believe that metformin can act as a magic weight loss pill, but this is usually not the case. 
If you are struggling with insulin resistance and ready to make lifestyle changes (altering your diet and adding in regular exercise), talk with your doctor about incorporating metformin into your routine to aid in weight loss. 
However, taking metformin alone will not cause substantial weight loss. 
 
What to do if you are losing too much weight on metformin 
If you are taking metformin for insulin resistance, but feel that you are losing too much weight (or losing weight when you don’t want to), know that any initial side effects, such as gastrointestinal discomfort, typically go away over time.  
There may be other causes contributing to your weight loss, such as:
Higher-than-normal blood sugar levels
Ketones in your urine 
Other medications (thyroid or cancer drugs like chemotherapy, for example) 
Chronic diarrhea 
Stress 
Anxiety 
Irritable Bowel Syndrome (IBS)
Food allergies 
Food intolerances, like Celiac Disease 
Depression 
Infection
If you are losing weight rapidly and don’t know why, call your doctor immediately. 
They will be able to help you troubleshoot a solution, and potentially stop your metformin treatment, if needed. 
Can I take metformin for weight loss without having diabetes? 
In some instances, metformin may be prescribed to people who do not have diabetes but are still struggling with prediabetes or insulin resistance. In these cases, weight loss would be a side effect of improving one’s insulin resistance.  
Talk with your doctor if you feel you are experiencing insulin resistance and/or decreased insulin sensitivity. 
If you don’t have prediabetes or insulin resistance, a doctor may prescribe metformin “off-label” (without FDA approval) for moderate weight loss. 
There are fewer peer-reviewed studies on the success of using metformin off-label, but many people have found success when incorporating metformin use with a healthier diet and exercise. 
 
Conclusions 
Considering all factors, metformin can cause a modest amount of weight reduction in those who take the medication regularly, although average weight loss is only between 4-7 pounds per year. 
This is why metformin is not classified as a weight-loss drug, but merely a prescription medication to help those with insulin resistance better manage their blood sugars. 
If you are overweight and/or obese, are taking metformin, and wish to experience sustainable weight loss, work with your doctor on figuring out a dietary plan and exercise regimen that will work for you.  
If you wish to take metformin solely for weight loss, talk with your doctor to see if you are able to use it “off-label”. Your doctor will work with you to determine the appropriate starting dose. 
Keep in mind that once you stop metformin therapy, there is a good chance your weight loss will plateau, and you may even gain back any weight that you’ve lost. This is why it’s important to incorporate a healthy diet and a regular exercise routine along with taking metformin for weight loss.
If you’re worried about the amount of weight you’re losing while taking metformin, contact your doctor, who can troubleshoot solutions with you, including potentially weaning you off of the medication. 
Should You Take Metformin for Weight Loss? Maybe.
Home  Health  Is Metformin Better for Weight Loss Than Ozempic?
Here’s what you can expect from taking the drug if you’re not diabetic.
Medications that are generally prescribed to diabetics to help them manage their blood sugar —including Ozempic and Wegovy—have recently been approved by the FDA to help some people lose weight. This has created a buzz and a big demand (so much so that people Type 2 diabetes struggled to get them for a while).
Another diabetes drug that’s generating a lot of attention as a potential weight loss aid? Metformin. Unlike Wegovy and Ozempic, metformin hasn’t been FDA approved for this purpose. Meaning: it’s not a weight loss drug, per se. But some doctors are prescribing it “off-label” to patients who are at risk for developing Type 2 diabetes.
Are you wondering how metformin might help with weight loss—and whether you should ask your doctor about it? We’re here to answer your Q’s.
What is Metformin?
Metformin is often the first medication prescribed to people with Type 2 diabetes to help lower their glucose (blood sugar) levels.
Metformin is a man-made derivative of a compound found in abundance in the French lilac plant, which has been used for blood sugar control since the Middle Ages. In 1957 it started to be used as an antidiabetic drug; by the ’90s it became a first-line choice to help treat Type 2 diabetes mellitus (1).
How Does Metformin Work?
It’s not entirely clear, but researchers suspect a few mechanisms. The medication causes your liver to lower the amount of glucose it makes and releases into your bloodstream. It also appears that it can act via an energy regulator in cells called AMP-activated protein kinase (AMPK), which can lower the amount of glucose in your bloodstream.
Together, these mechanisms of action bolster insulin sensitivity—a good thing, since people with diabetes usually have some level of insulin resistance.
Metformin also slows the absorption of glucose helping to manage blood sugar levels (2).
 METFORMIN 
How Does Metformin Cause Weight Loss?
Researchers are still working to understand how metformin helps with weight loss. But they have some theories.
Promoting insulin sensitivity
Much of your food intake gets converted into glucose. Under normal circumstances, when that glucose enters your bloodstream, cells in your pancreas release insulin. Insulin triggers your cells to gobble up the glucose for energy. When glucose enters your cells and the levels in your bloodstream decrease, it signals your pancreas to stop producing insulin. Excess glucose gets stored in the liver as glycogen or as fat.
For several reasons, your cells can fail to efficiently take up glucose from your blood or store it. This is called insulin resistance. The result: your pancreas pumps out more of the hormone, trying to overcome your increasing glucose levels. If your cells become too resistant to insulin, elevated blood glucose levels will follow, and, over time, can lead to prediabetes and Type 2 diabetes.
Metformin increases insulin sensitivity, reduce insulin resistance, and improves insulin action in type 1 diabetes (3). Metformin may also help put the brakes on your weight gain, which is associated with insulin resistance. And in numerous studies, metformin has improved insulin sensitivity, which can improve insulin resistance. Insulin resistance and obesity have a complex association with each other (4).
Boosting appetite-suppressing hormones
The use of Metformin may lead you to feel less hungry.
Metformin, like Wegovy and Ozempic, appears to increase the secretion of GLP-1, a hormone that helps delay stomach emptying and sends “I’m full” signals to your brain (5). GLP-1 can also have a positive effect on insulin-producing pancreatic cells by increasing insulin secretion and production (6). Evidence suggests that people with obesity may have reduced GLP-1 secretion1 (7). That loss of appetite may lead you to eat less. 
Metformin also is thought to make your body more sensitive to leptin, a hormone that helps control appetite (8). Too much leptin can lead to leptin resistance, which may increase hunger and drive you to eat more (9). Metformin’s actions on leptin may help curb hunger.
Changing your gut microbiome
Metformin treatment may alter gut microbiota, in part, by boosting the production of short-chain fatty acids (SCFAs). SCFAs appear to have metabolic health benefits, including increasing evidence that they may make us more insulin sensitive, improve appetite regulation, and more (10, 11).
Battling ‘inflammaging’
Metformin is also being studied as a longevity-promoting drug, because it appears that it may boost mitochondrial function and combat inflammation (12). Mitochondrial dysfunction and low-grade systemic inflammation (inflammaging) are also linked to obesity (13).
 WEIGHT LOSS 
How Much Weight Can You Lose on Metformin?
Less than you might expect.
A research review found that most people lost more weight than those who took a placebo (14). But weight loss results on metformin vary.
One long term study published in 2019 found that 28.5% of those taking metformin lost about 5% or less of their body weight during the first year. And those who lost weight on metformin during the first year had the greatest success with weight loss during years 6-15 (15).
An older study found that people with obesity or having higher body fat and taking metformin for six months lost around 12 to 15 pounds. Those with more severe insulin resistance tended to lose more than those who had insulin sensitivity (16). And a research review of studies with participants where the average age was 60 years or older, found about a 3.5-6 pound weight loss difference in those treated with metformin when compared to those given a placebo (17).
All told, the research suggests a potential 5- to 15-pound average weight loss with metformin.
How Fast Will You Lose Weight on Metformin?
Based on the above studies, any weight loss with metformin appears to occur over the course of about 6 to 12 months. But people may see some results earlier.
Metformin may help you lose weight and ward off age-related illnesses. 
Can People Without Diabetes Take Metformin for Weight Loss?
Some doctors are prescribing metformin off-label to people with prediabetes to help them avoid developing diabetes. Physicians may also prescribe metformin to non-diabetic individuals to help treat obesity and weight gain from taking antipsychotic medications (18).
In people with obesity, achieving and maintaining weight loss can be challenging for many reasons, including because of the complex hormone signaling processes at play, even if they exercise and watch their diet. But metformin works best in tandem with lifestyle changes, regular exercise, and improved nutrition (19).
Metformin for Weight Loss Dosage
Metformin is available in different dosages and as an immediate-release and extended-release option. Patients usually start on a lower dose with the potential for an increase over time (19), but you should take the dose your doctor prescribes.
Common Side Effects and Precautions
Like any other drug, there are potential side effects of metformin. The most common are gastrointestinal side effects, including nausea/vomiting and diarrhea (19). You may also experience:
bloating/gas
constipation
headache
heartburn
upset stomach 
unpleasant taste in mouth
 
More serious but rare side effects include anemia or hypoglycemia (low blood sugar). Although extremely rare, lactic acidosis—which can be a medical emergency—may be caused by too much metformin in the body. Lactic acidosis is when the body produces too much lactate or underuses it, causing a pH imbalance. Symptoms of lactic acidosis include the following:
loss of appetite
dizziness/lightheadedness
extreme fatigue or weakness
fast/slow heart rate
feeling cold
muscle aches/pain
nausea/vomiting
skin flushing/warmth
stomach pain
breathing trouble
fruity-smelling breath
confusion
jaundice
 
One last caveat: If you take metformin for weight loss, you may need to stay on metformin long term to maintain any results. 
 GET MET 
The Bottom Line
Weight management is complex, for many reasons, for example, because a host of hormone signaling processes that regulate metabolism and appetite are involved. That’s why anti-diabetes medications like metformin are sometimes used to aid weight loss. Weight loss on metformin tends to be modest, and it occurs slowly over time, but it’s a medication that can be used as a helpful tool in conjunction with a healthy diet and lifestyle habits.
Metformin may help you lose weight and ward off age-related illnesses. 
 References
 
1. Bailey, Clifford J. (2017). Metformin: Historical Overview.
2. Rena, Graham, et al. (2017). The Mechanisms of Action of Metformin
3. Beysel, S. et al. (2018). The Effects of Metformin in Type 1 Diabetes Mellitus.
4. Barazzoni, Rocco, et al. (2018). Insulin Resistance in Obesity: An Overview of Fundamental Alterations.
5. Bahne, Emilie, et al. (2018) Metformin-Induced Glucagon-like Peptide-1 Secretion Contributes to the Actions of Metformin in Type 2 Diabetes.
6. Latif, Wafa, et al. (2023). Compare and Contrast the Glucagon-like Peptide-1 Receptor Agonists (GLP1RAS).
7. Lee, Chooi Yeng. (2021). A Combination of Glucagon-like Peptide-1 Receptor Agonist and Dietary Intervention Could Be a Promising Approach for Obesity Treatment.
8. Tang, Xuemei, et al. (2016). Metformin Increases Hepatic Leptin Receptor and Decreases Steatosis in Mice.
9. Barrios-Correa, et al. (2018). Leptin Signaling in the Control of Metabolism and Appetite: Lessons from Animal Models.
10. Mueller, Noel T., et al. (2021). Metformin Affects Gut Microbiome Composition and Function and Circulating Short-Chain Fatty Acids: A Randomized Trial.
11. Blaak, E.E., et al. (2020). Short Chain Fatty Acids in Human Gut and Metabolic Health.
12. Bharath, Leena P., et al. Metformin Enhances Autophagy and Normalizes Mitochondrial Function to Alleviate Aging-Associated Inflammation.
13. Livshits, Gregory, and Alexander Kalinkovich.
 (2019). Inflammaging as a Common Ground for the Development and Maintenance of Sarcopenia, Obesity, Cardiomyopathy and Dysbiosis.
14. Lentferink, Y. E., et al. (2018). Efficacy of Metformin Treatment with Respect to Weight Reduction in Children and Adults with Obesity: A Systematic Review.
15. Apolzan, John W., et al. (2019). Long-Term Weight Loss with Metformin or Lifestyle Intervention in the Diabetes Prevention Program Outcomes Study.
16. Seifarth, C., et al. (2012). Effectiveness of Metformin on Weight Loss in Non-Diabetic Individuals with Obesity.
17. Solymár, Margit, et al. (2018). Metformin Induces Significant Reduction of Body Weight, Total Cholesterol and LDL Levels in the Elderly – a Meta-Analysis.
18. de Silva, Varuni Asanka, et al (2016). Metformin in Prevention and Treatment of Antipsychotic Induced Weight Gain: A Systematic Review and Meta-Analysis.
19. Fortamet (Metformin Hydrochloride) Dose, Indications, Adverse Effects, Interactions.
 Prescriber’s Digital Reference. Accessed January 13, 2023.
HEALTHY WEIGHT LOSS
 Metformin for weight loss| which metformin is better to take for weight loss 
 Obesity causes significant harm to the human body. This is manifested by a load on the joints, an increase in the level of cholesterol in the blood and the development of diseases of the cardiovascular system. Especially dangerous is the deposition of fat reserves in the upper body and abdomen, which leads to an increased risk of stroke, ischemia and cancer.
 What is metformin? 
 When it is not possible to fight extra pounds through the use of physical activity and dieting, many people who are losing weight turn to medical methods for help. Metformin is one of the drugs commonly used for weight loss. The drug was intended for the treatment of diabetics, but due to side effects has become popular among those looking for a “magic tool” for weight loss. To understand how pills work, you first need to study how it affects the body.
 The drug is presented as a white powder, readily soluble in water. The use of the drug leads to the activation of the following processes:
 Decreased glucose level;
 Reduces blood cholesterol levels;
 Increased tissue sensitivity to insulin;
 Eliminates the risk of dystrophy of internal organs;
 Restores lipid concentration;
 Carbon exchange normalizes.
 In addition to the active substance itself, the tablet contains:
 Cornstarch;
 Magnesium stearate;
 Talc;
 Povidone.
 Is it possible to lose weight on metformin? 
 The drug has a significant effect on lowering blood glucose levels, but this does not always lead to weight loss. If you take pills according to the instructions and do nothing else, it is unlikely that you will be able to achieve a positive result in weight loss.
 Pluses and minuses 
 This potent drug leads to disruption of the natural processes of the human body. Therefore, carefully study all the positive and negative aspects of its use. However, do not expect miracles and magic from the use of pills alone.
 Pros:
 Reasonable price;
 Possibility of combination with fat-burning drugs;
 Minimal risk of complications;
 Although the advantages of the drug are significant, there are also disadvantages.
 Minuses:
 Habituation and decrease in the effectiveness of the drug with a long course of use;
 It is impossible to get a full result without following a dietary program;
 A large number of contraindications.
 Mechanism of action 
 The drug has a hypoglycemic effect. Under the influence of the drug, the concentration of glucose in the blood decreases. In parallel, the level of hemoglobin decreases and glucose tolerance is developed.
 Beta cells of the pancreas produce insulin in the same mode without changes.
 There is a normalization of the lipid content in the plasma in patients with diabetes, which is manifested by a decrease in the level of triglycerides and cholesterol.
 In addition, metformin slows down the production of adenosine triphosphoric acid in special cellular structures – mitochondria.
 Blood sugar decreases due to the following processes:
 Inhibition of glucose production from non-carbohydrate compounds;
 Increased tissue sensitivity to insulin;
 Active utilization of glucose by cells;
 Slowing down the absorption of glucose in the small intestine.
 In the gastrointestinal tract, the drug is rapidly absorbed. Full bioavailability in the blood is achieved two hours after application. The active substance does not react with blood proteins.
 The accumulation of metformin occurs in the salivary glands, muscles, kidneys and liver.
 In an unchanged state, the drug is excreted from the body through the kidneys.
 The drug interferes with the process of assimilation of carbohydrates due to inhibition of the production of hepatic glycogen. This process is called an energy deficit, which develops with a feeling of hunger. But at the same time, a person does not suffer from unpleasant sensations, repeat. due to low levels of insulin in the blood.
 High efficiency can not be expected due to the fact that the drug does not belong to the group of fat burners. The main task of the drug is to reduce appetite, and fat deposits are eliminated in other ways.
 Indications for use 
 Metformin is prescribed by specialists in the following cases:
 Type 2 diabetes mellitus.
 High risk of developing diabetes;
 The appearance of a large number of cysts in the ovaries (polycystic ovary syndrome, PCOS). For the treatment of this disease, the drug began to be used as early as 90s of the last century. Doctors have identified a relationship between increased insulin production and the development of cysts. Due to the hypersecretion of the hormone, the metabolic process in the reproductive tissues of the body is disturbed. According to the results of experimental treatment, 80% of ill women recovered;
 Treatment of obesity;
 Metabolic syndrome.
 Course duration 
 The manufacturer recommends using the drug for three weeks. Experts advise not to exceed the specified period of application. After the end of twenty-one days, the body becomes accustomed to the drug. This results in a marked decrease in efficiency. The body stops responding properly to taking pills. This is the first reason why you should not neglect the opinion of a specialist.
 The second is the possibility of harm to the human body due to a long absence of carbohydrates. To ensure a normal and full life activity, it is necessary to create a balanced diet, and this cannot be done without carbohydrates. After completing a three-week course, it is better to take a month break.
 Side effects 
 Manufacturers talk about the complete safety of the drug, but you should not believe this one hundred percent. This is a drug that, like all other medicines, has the ability to cause side effects. Thanks to the research of doctors, it was found that the most dangerous moment for the development of side effects is the first days. Symptoms of developed reactions pass on their own, but in severe cases it is better to seek help from specialists.
 Possible consequences:
 Headache;
 Spasmodic pain in the abdomen;
 Nausea;
 Anemia;
 Development of impotence;
 Lactic acidosis;
 Urticaria;
 Gastrointestinal disorders manifested by vomiting, diarrhea and anorexia.
 Under the influence of metformin, a violation of the habitual activity of the body occurs. Lactic acidosis is the most life-threatening side effect. The cause of the disease is a violation of the metabolism of lactic acid and its further, uncontrolled accumulation.
 Clinical picture of lactic acidosis:
 Nausea;
 Vomiting;
 Vertigo;
 Loss of consciousness;
 Diarrhea.
 At the first appearance of such signs, immediately seek medical help.
 Side effects may develop with an overdose. Women and men, in pursuit of a quick weight loss result, try to increase the dosage. Some increased the allowable dose of 1500 mg per day. Lactic acidosis in this case is inevitable. And it can lead to death. Without the assistance of specialists, a person first falls into a coma, and then dies.
 The most effective way to deal with overdose is hemodialysis. After it, complex symptomatic therapy is carried out.
 Contraindications 
 At home, it is recommended to use metformin with great caution. Before using, carefully read the instructions, the opinion of doctors and nutritionists.
 Take the time to examine your own body: check the kidneys, liver, heart and, of course, the pancreas. All these measures will be very useful because the list of contraindications is long:
 Type 1 diabetes mellitus;
 Renal failure, kidney disease;
 Cirrhosis, hepatitis;
 Heart failure;
 Severe past trauma;
 Postoperative period;
 Chronic alcoholism;
 Breastfeeding;
 Simultaneously following a low-calorie diet;
 Do not combine with diuretics and laxatives.
 Metformin is not recommended for children due to lack of research. What? The simultaneous use of medication and alcohol is not the best solution. This combination significantly increases the chances of developing lactic acidosis. Therefore, during the period of use of the drug, it will be necessary to completely exclude alcohol and products that include ethanol.
 Naturally, during pregnancy and feeding, the use of the drug is inappropriate due to the potential risk to the child or fetus. If a woman took metformin, and then found out about the onset of pregnancy, then she will have to abandon it and start using insulin. In the case when treatment with the drug is required at the stage of breastfeeding, it will be necessary to wean the child from the breast.
 How to use Metformin for weight loss? 
 It is strictly contraindicated to use Metformin without consulting a doctor.
 The tablet must be swallowed completely with plenty of clean water. According to the instructions, the initial dosage should be 500 mg per day. The maximum you can use 2-3 gr. The best time to take the tablets is before bed. Increasing the dosage should be a gradual process. If you immediately take large doses, inevitably a violation of gastric function and disorders of the digestive system. Of the symptoms of an overdose at the initial stage, nausea and a metallic taste in the mouth are noted.
 Application scheme:
 The first seven days the drug is taken once a day, 500 mg;
 Gradually, the dosage is increased to 850-1000 mg and divided into two doses;
 In case of unstable metabolism and the simultaneous use of a dosage of 2000 mg per day, insulin will have to be used in parallel;
 A specialist will help you choose the scheme of admission. It depends on the individual indicators of the human body. The sugar content has a particular influence on increasing the dosage.
 In order not to harm your own health, always listen to the recommendations of experts. Do not try to solve problems with excess weight by medication on your own.
 Admission Rules 
 To achieve the desired result in the process of losing weight, you should adhere to the following rules:
 Arrange an appointment with a doctor
 Observe drinking regimen;
 Strictly observe the dosage of the drug;
 Discontinue if discomfort occurs
 We all know that some foods contribute to the rapid set of extra pounds. These include: flour, potatoes, sweet, fatty and alcohol. These foods should be limited.
 Metformin diet 
 As has been said more than once, diet is definitely important when losing weight. If you know that it is difficult to eliminate the use of carbohydrates, then it is better not to start taking the drug. Because the active substance does not burn fat deposits, it makes the cells of the body work more actively. It does this by lowering blood glucose levels. Due to its decrease, fat reserves become a source of energy. But, if the concentration of glucose for some reason does not decrease, then the weight will stay in place. Therefore, when taking metformin, you should carefully monitor the foods you eat.
 Read the recommendations of experts about the diet:
 Calculate your individual daily calorie intake. Try our BEST calorie control guide WITHOUT calorie counting –  get on whatsapp. 
 Don’t starve when you’re stressed. Suppress hunger with nuts or unsweetened fruits;
 Observe the drinking regimen. The daily norm of liquid is not less than 1.5 liters;
 You need to eat fractionally, several times a day. The optimal number of meals is five times;
 Sleep at least 7 hours a day
 When cooking, it is better to use boiling, stewing and baking;
 The main diet should be food containing a large amount of protein. This includes lean meat and fish. Good for cottage cheese. The daily protein intake is calculated individually for each person, depending on weight and gender. So, it is possible to control the feeling of hunger and keep glucose at a minimum level. Due to this, as already mentioned, the cells of the body burn fat deposits, using them as energy.
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 Physical activity while taking Metformin 
 Physical training of any kind will greatly enhance the effect of the drug. Sports activities help to actively burn body fat. Choose the exercises that you enjoy. It can be morning jogging, cycling or horseback riding, yoga, fitness, sports dancing and much more. In addition to a noticeable result on the scales, one can note the positive mood that remains after sports training.
 Metformin for weight loss: reviews and recommendations of doctors 
 Before you start using metformin, you should go to the doctor, who will tell you whether to start taking it or not.
  — Is glucose really dropping? 
 – Yes, under the influence of the active substance, its concentration in the blood is significantly reduced. This is noted by diabetics, for whom this factor plays a leading role in the application.
  – What can not be done categorically? 
 – In no case should you start taking without consulting a doctor. After starting the reception, you can not combine taking the drug with the use of alcoholic beverages.
  — How to prepare for taking the drug? 
 – Be sure to visit a doctor, let him prescribe the necessary tests and evaluate the results of body tests.
  — Is it possible to take metformin in parallel with antibiotics? 
 – The combination of drugs must be under the strict supervision of a physician.
  — Which drug of Metformin to choose in a pharmacy? 
 – The choice will depend on your financial capabilities, personal preferences and the availability of funds.
  — Can the medicine be combined with Hepar compositum or Senade? 
 – Yes, you can.
 Do not try to quickly lose extra pounds by increasing the allowable dosage many times over. Thus, it will only be possible to achieve an overdose and the development of side effects.
 Remember that the active substance of the drug is not aimed at directly combating extra pounds and body fat.
 Expert opinion 
 .
 In conclusion, I would like to repeat once again that people who want to lose weight quickly and for a long time will not be able to achieve the desired result solely on pills. Moreover, do not try to quickly lose extra pounds by increasing the allowable dosage of any drug. Thus, it will be possible to achieve only an overdose and side effects. Remember that the active substance of any drug is never aimed at directly combating the extra pounds of your body fat. 
 We urge you to form healthy eating habits: this is something that no one will take away from you, even if the production of all medicines stops in the world! Rational eating behavior is the key to your health, and it is inside you, not the experts in fitness, nutrition, pharmaceuticals and other worthy industries. Cultivate this key for yourself, and we will be happy to help you
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 Is metformin the cure for everything? Yes, but no 
 We love metformin very much and talk about it at every opportunity. Today it suppresses the growth of cancer cells, tomorrow it fights inflammation, the day after tomorrow it helps to lose weight, and next week it completely prolongs life. Readers might get the impression that this medicine overcomes any disease. Unfortunately, this is not entirely true, and almost every good news comes with a “yes, but”. So we decided to write about metformin again – this time a large text that will explain to those who missed everything, where this drug came from, what they are being treated for and how successfully.
 History 
 It all started with grass. Goat’s rue, aka goat’s rue, aka Italian ferret, aka, scientifically,  Galéga officinalis  is a perennial herb. In medieval Europe, they were treated for frequent urination – one of the symptoms of diabetes – and some other diseases. It is difficult to say how long goat’s rue has been used in folk medicine, but it is known that the famous English doctor Nicholas Culpeper mentioned it back in 1652 in the book The English Doctor.
 At the end of the 19th century, scientists came to grips with goat’s rue and found out that it contains large amounts of guanidine (this colorless crystalline substance was first synthesized in 1861). In 1918, during experiments on rabbits, scientists showed that guanidine lowers blood glucose levels. But the compound turned out to be too toxic, and it was impossible to treat people with it, so scientists began experimenting with guanidine derivatives. In 1922, Emil Alphonse Werner and James Bell obtained dimethylbiguanidine, known to us as metformin, in the process of synthesizing N, N-dimethylguanidine, and seven years later, the German scientist Karl Slotta tested it on animals . There were other drugs based on guanidine – galegin (isoamylene-diguanidine), biguanides Syntalin A and B. Syntalins were even used in clinical practice for some time, but after the industrial production of insulin began (in 19In 23, the company  Eli Lilly and Company  began selling it under the name “Iletin”), they forgot about guanidine derivatives.
 In 1949, metformin fell into the hands of Eusebio Garcia, a Filipino infectious disease specialist. He called the substance “flumamine” and used it to treat influenza and malaria. A year later, in the article Fluamine, a new synthetic analgesic and antiflu drug (Flumamine: a new synthetic analgesic and antiflu drug), Garcia said that a single injection of the drug relieved the headache of thirty patients and completely cured them in 24 hours. The doctor did not know the exact mechanism of action, and suggested that flumamine reduces the concentration of sugar in the blood, but did not provide any evidence.
 These speculations were enough to interest another physician, the French diabetologist Jean Sterne. He conducted experiments on dogs, rats and rabbits and found that six months of treatment did not affect either their development or liver function. Even an autopsy failed to detect any anomalies. Stern conducted clinical trials on humans, called the drug “glucophage” (“sugar eater”, by analogy with bacteriophage) and began to treat diabetics with it.
 French doctor Jean Stern and the hospital where he studied metformin.
 Metformin almost immediately had competitors – more powerful phenoformin and buformin. But these drugs caused lactic acidosis, a dangerous condition that is accompanied by CNS depression, respiratory failure, cardiovascular system functions and urinary excretion. Therefore, by the end of the 70s they were no longer used in most countries. And then metformin became the main alternative to insulin. In the late 50s it was sold in France and the UK, in the 70s in Canada, and it entered the American market only after approval by the Food and Drug Administration (FDA) in 1994 year. There it quickly became a “bestseller”
 What we know about metformin 
 Metformin is now considered the “first line drug” for the treatment of type 2 diabetes. Its main advantage is that it practically does not cause hypoglycemia, which distinguishes it from insulin and another class of hypoglycemic agents – sulfonylurea derivatives. Metformin reduces the concentration of glucose in the blood by inhibiting its formation in the liver, while sulfonylurea drugs increase the release of insulin from beta cells in the pancreas. In addition, it does not contribute to weight gain. Of course, he also has side effects, unpleasant, but not fatal: the most common are gastrointestinal disorders, in particular, nausea, vomiting, flatulence and diarrhea. And a decrease in appetite is even useful.
 Much of what we know about the health effects of metformin comes from clinical studies. This drug was originally developed to lower blood sugar, and was studied, of course, primarily in the context of diabetes. In order to talk about the advantages and disadvantages of metformin, you need to at least talk a little about how doctors obtained this information – otherwise the story will turn into “scientists have proven”. Here are some of the most significant type 2 diabetes clinical trials:
 – The University Group Diabetes Program,  UGDP 
 – United Kingdom Prospective Diabetes Study,  UKPDS 
 – Diabetes Prevention Program, 9039 0 DPP  (Prevention Program diabetes)
  UGDP  was the first randomized clinical trial focused on diabetes. 1027 people took part in it, the study lasted 21 years, from 1960 to 1981, and the first results were published in 1970. The scientists wanted to know which drug was most effective in preventing the development of cardiovascular complications. The clinical trial was heavily criticized, including due to randomization errors. However, the FDA found no reason not to trust his findings. Participants did not take metformin, but the UGDP declared phenformin, another drug of the same class, ineffective, and as a result, the drug was not approved “by analogy” for use in the United States. It was thanks to UGDP that the release of the drug on the market in this country was postponed for many years.
  UKPDS  was the largest clinical trial to date, with 5102 patients with type 2 diabetes. The test lasted 20 years, from 1977 to 1997. The UKPDS was supposed to answer the question: can intensive blood glucose control prevent the development of complications, and what is the best medicine for this? Participants were taking first-generation sulfonylurea drugs, insulin, or were on a diet. After the publication of the results, doctors began to recommend metformin more often.
 3,234 people participated in  DPP . The aim of the study was to find the most effective way to prevent type 2 diabetes in people with prediabetes. To do this, one group was offered diet, exercise, and lifestyle changes, the other was metformin, and the third was a placebo. After the clinical trial, another one was conducted – the Diabetes Prevention Program Outcomes Study, DPPOS or, in Russian, Diabetes Prevention Program Outcomes Study. Doctors studied the health status of DPP participants after 15 years.
 Only overweight patients received metformin during the UKPDS. The results showed that the drug reduced the risk of death from diabetes complications by 42% and all-cause mortality by 36%. A good result, but it is not so impressive, considering that the medicine was compared with an ordinary diet. The risk of cardiovascular complications in patients on metformin, insulin and sulfonylurea drugs was practically the same. Paired with urea derivatives, the drug even increased mortality. But, unlike other drugs, metformin did not contribute to weight gain and less often caused hypoglycemia. Therefore, scientists have proposed nothing less than appointing metformin as a first-line drug in the treatment of patients with obesity. This marked the beginning of his popularity.
 DPP/DPPOS have shown that taking metformin can reduce the risk of developing diabetes in people with prediabetes by 31%. But it’s better to change your lifestyle anyway – in this case, the incidence decreases by 58%. Good old physical education and diet turned out to be almost 2 times more effective. But the drug showed another advantage – metformin helped to lose weight. People with prediabetes who took the drug lost about two kilograms on average. The effect persisted as long as the study participants took the pills, and the drug was well tolerated.
 Of course, there have been other studies of metformin and even meta-analyses of these studies. However, we still do not know everything about the advantages and disadvantages of this drug. For example, scientists are still trying to figure out how metformin affects the development of cardiovascular diseases and mortality – data on this subject are contradictory. A review of 30 papers from 2011 found that a diabetes drug does not cause significant harm or significant benefit to the heart, and only looks good compared to placebo or no treatment at all. An article from 2016, which analyzed 300 studies, says that there is no difference at all in terms of mortality and cardiovascular disease between the nine classes of antidiabetic agents. However, the authors of the analysis admit that there was a high risk of bias in the selected articles – more than half of the publications presented information selectively, and sponsors were involved in the work on them. On the other hand, a recent study based on 17 publications shows that in patients with chronic kidney disease, congestive heart failure and chronic liver failure, metformin still reduces mortality.
 New use 
 In Russia and the US, metformin is only approved for type 2 diabetes, but other diseases are also being tried. And the more it becomes known about the mechanisms of action and the effect of the drug on the body, the more actively they are looking for a new application.
 It has long been known that metformin is associated with weight loss. DDP and DDPOS did not open the eyes of doctors, but only confirmed previous observations. Therefore, doctors tried to treat healthy obese people with metformin. One of the first such studies was published in 1970 in  Lancet  . Scientists compared the effectiveness of metformin and fenfluramine on the example of 34 women aged 22-59 years. After 8 weeks of therapy, they concluded that fenfluramine worked better and had fewer side effects.
 Works from 1998 and 2001 rehabilitated the hypoglycemic drug and showed that it also reduces weight in non-diabetics, but later a meta-analysis came out that called these results into question. The researchers selected 57 studies and excluded 48 of them because they did not meet the standards for conducting clinical trials. Only 9 left- and after the analysis it became clear that there is not enough data on the effectiveness of metformin. Three years later, another review came out and confirmed the results of the previous one. Metformin seemed to reduce weight by 3-9 kilograms, but the sample of such studies was small, the duration was short, and the design was “weak”. In addition, the participants, in addition to taking the medicine, were engaged in physical education – try to figure out what exactly helped them lose weight. Several longer trials, devoid of these shortcomings, showed only a slight reduction in weight.
 Four years ago, the results of perhaps the largest clinical study on the treatment of obesity in non-diabetics were published. If in previous works it was about three to four dozen people, now there were 200 volunteers. 20% could not lose weight at all, and 9 people gained it. The remaining participants in the study lost, on average, 5% of body weight, and most of all, the drug helped people with impaired insulin susceptibility. But this study also had a methodological catch: there was no randomization of the control group.
 Overweight children and adolescents are also treated with metformin, but not particularly well. In 2016, Cochrane, an international NGO that studies the effectiveness of health technologies, presented a systematic review and showed that not only metformin, but other drugs in this population are ineffective. And the quality of the available data leaves much to be desired. In general, doctors admit that it is too early to recommend a diabetic drug for the treatment of obesity to both children and adults. The problem is still solved mainly by diet and exercise.
 Another use of metformin is in the treatment of polycystic ovary syndrome (PCOS). PCOS is a condition in which a woman’s levels of male hormones (androgens) are elevated, ovarian function is disrupted, and the menstrual cycle is disrupted. As a result, ovulation does not occur, and it becomes difficult (although not always impossible) to get pregnant. In many patients, excessive growth of hair on the face and body begins, acne appears, and about half gain excess weight. It was not possible to fully understand the causes of PCOS, and it is not possible to cure it once and for all. But it is already known that the disease is associated with tissue insensitivity to insulin, and women with this syndrome have an increased risk of developing type 2 diabetes. Metformin, which fights insulin resistance, seems to come in handy here.
 But it’s not that simple. In 1994, the drug proved itself well – then Venezuelan scientists conducted a study with the participation of 29 women, 7 of whom had their menstrual cycle restored, and three spontaneously became pregnant. “Metformin can reverse many, if not all, of the metabolic disorders of PCOS,” the authors wrote. True, they immediately stipulated that they did not conduct randomization and did not use a placebo for comparison. However, the larger and more elaborate clinical trials of 2006-2007 did not confirm the optimistic assumptions. Metformin stimulated ovulation was not particularly effective and was inferior to clomiphene (trade name – Clostilbegit).
 According to the clinical guidelines of the International Endocrine Society, a diabetic drug helps with metabolic disorders and irregular periods, but is limited or not effective in the treatment of infertility, acne and excessive hair growth. Participants of a seminar organized by the American Society for Reproductive Medicine came to a similar conclusion. They recommended metformin only for women with impaired glucose tolerance. But a 2014 Cochrane review says that the drug is more effective than placebo and increases the chance of getting pregnant. True, the quality of the evidence base of studies was recognized as low, and the probability of error was recognized as high.
 Metformin can theoretically help fight cancer. But how these hopes are justified remains to be seen. They began to seriously look at the medicine from this side only 12 years ago – an insignificant period, if you remember how long, for example, the UKPDS lasted. In 2005, Josie Evans and her colleagues at the University of Dundee reported that metformin reduces the incidence of cancer among diabetics by 23%. They came to these conclusions after analyzing data from the DARTS electronic medical database.
 The publication inspired the rest of the medical profession, and they began to cross-check the conclusions of colleagues with the help of other medical registries. Gradually, the benefits of metformin were confirmed by more and more studies. Reviews of scientific papers appeared that showed a decrease in incidence at the level of 31-34%. Then – experiments on cell cultures and mice. It turned out that in rodents under the influence of a diabetic drug, the growth of tumors slows down by as much as 50% – however, they were fed the drug in doses exceeding human doses.
 Why can’t we please our readers and say that we have finally found a new effective cure for cancer? For two reasons. Firstly, there is no abstract “cancer” – it is a collection of different oncological diseases. How effectively metformin fights each of them needs to be tested in clinical trials, and this process is still far from complete. Second, the credibility of the data that sparked enthusiasm at an early stage was called into question. In two dozen papers, errors were found that could distort the results. And where they did not find, they did not find a connection between metformin and cancer incidence. In general, more time is needed, more research is needed.
 Metformin and aging 
 If metformin is mentioned in the media, the article is probably about life extension. Gerontologists look at the old drug with hope, and they have good reasons for this. First, in recent years, scientists have begun to actively explore the molecular and genetic mechanisms of aging. Studies show that calorie restriction increases the lifespan of mice and rats by about 30-40%. According to an article published this year, such “therapeutic fasting” prolongs the life of primates. “What does metformin have to do with it?”, you ask. According to some scientists, metformin causes approximately the same changes in the body as calorie restriction: increases sensitivity to insulin, lowers cholesterol, improves physical condition. Yes, and gene expression in rodents fed with metformin resembles that of animals on a low-calorie diet.
 So the scientists set out to test the effect of the drug on model organisms. Metformin-treated Caenorhabditis elegans worms lived 18-36% (dose dependent) longer than their control counterparts. Mice — by 5%. By the way, similar experiments were carried out here in Russia, at the Research Institute of Oncology. N. N. Petrova. Scientists fed metformin not to ordinary rats, but to a breed created specifically for the study of hypertension and cardiovascular disease. In such animals, the average life expectancy increased by 37.8%. Gerontologists even got to the crickets: in the species Acheta domesticus, after treatment with an antidiabetic drug, the maximum life expectancy was 138% compared to the control group.
 Human trials would be the next logical step. The results of one such study have already been published. Scientists analyzed the data of 180,000 people: 78,000 had diabetes and took metformin, 12,000 drank sulfonylurea drugs, and 90,500 were healthy. This information was not obtained from a double-blind, placebo-controlled trial, but from the Clinical Practice Research Datalink database of medical records. The results showed that diabetics on metformin live 15% longer than healthy people. The media wrote about a drug that can prolong life, but some scientists have a work called “Can people with type 2 diabetes live longer than healthy people?” not at all impressed. Here is what Kevin McConway, a professor of applied statistics at the British Open University (The Open University), said about her:
 “The title of the article is misleading because whoever reads it may misunderstand it – in fact, this study cannot answer the question asked for reasons that I will give below, and one gets the impression that doctors have reasons recommend metformin to healthy people. But this is not what this study is about.
 In a press release, Craig Curry says “Once a person develops diabetes, their life expectancy is reduced by an average of 8 years” and further explains why. If diabetics live so much shorter than healthy people, how can they “live longer than non-diabetics,” as the headlines of the article and press release put it?
 The fact is that the study focuses on the period of time when diabetic patients received metformin as first-line therapy (this group is also compared with those who received sulfonylurea drugs as first-line therapy). At some point, many patients will be transferred to second-line therapy because diabetes or its symptoms worsen. But at this point, the study simply ends.
 So the 8-year reduction in life expectancy for type 2 diabetic patients refers to the patient’s entire life after diagnosis, including the period when they are on more aggressive second-line therapy. But the study only takes into account the length of time before changing the treatment regimen. This will not fit in a capacious headline, but it is important to note that everything is not so simple here.
 But if the survival of diabetics taking metformin is significantly higher than the survival of healthy people, albeit for a limited period of time, does this mean that people who do not have diabetes should take metformin to live longer? No, it doesn’t. Such a clear difference may not be due to metformin, but to something else. […]
 The difference in survival between diabetics on metformin and the control group was statistically significant, but, in fact, quite small and probably in the range that can be explained by residual confounding (the influence of other variables that are not taken into account in the analysis). ”
 In addition, it would be dishonest not to mention that the study was funded by pharmaceutical companies  AstraZeneca  and  Bristol-Myers Squibb  . Employees of these firms had access to the study data, although the article states that they could not influence the analysis, peer review, or publication process. And the scientists themselves are quite familiar with the pharmaceutical industry. Five worked for the research consulting company  Pharmatelligence , which receives grants from drug manufacturers. Another was an employee of  Bristol-Myers Squibb  . This in itself does not make the results unreliable, but, you see, it is somewhat alarming. Especially given the fact that both sponsor companies produce metformin.
 So without full-fledged clinical trials, this issue cannot be sorted out. One of the first studies on the relationship between metformin and aging was to be the Metformin in Longevity Study. But since the launch in 2014, no information has appeared about it. Preliminary results were supposed to be received two years ago, but since then not a single publication has been published.
 Another clinical trial, Targeting age with Metformin (TAME), is in the pipeline. This double-blind, randomized, placebo-controlled trial is the gold standard, just the way we like it. It will be attended by 3,000 people aged 65 to 79 years. TAME is rather unusual for several reasons. Firstly, it is aimed at studying what, as it were, does not exist. Aging, from a medical point of view, is not a disease. There is no generally accepted biomarker by which one could understand whether this process is slowing down or not. Therefore, the purpose of the study is to determine whether metformin can slow the development of age-related diseases: cardiovascular, neurological, oncological, and so on.
 Scientists hope they can set a precedent so that in the future the FDA will recognize aging as an “indication,” a condition that can be treated.