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Review
. 2019 Jun;8(2):156-164.
doi: 10.1007/s13679-019-00335-3.

Metformin: Mechanisms in Human Obesity and Weight Loss

Armen Yerevanian  1   2   3 , Alexander A Soukas  4   5   6
Affiliations
Review

Metformin: Mechanisms in Human Obesity and Weight Loss

Armen Yerevanian et al. Curr Obes Rep. 2019 Jun.

Abstract

Purpose of review: Metformin has multiple benefits for health beyond its anti-hyperglycemic properties. The purpose of this manuscript is to review the mechanisms that underlie metformin's effects on obesity.

Recent findings: Metformin is a first-line therapy for type 2 diabetes. Large cohort studies have shown weight loss benefits associated with metformin therapy. Metabolic consequences were traditionally thought to underlie this effect, including reduction in hepatic gluconeogenesis and reduction in insulin production. Emerging evidence suggests that metformin-associated weight loss is due to modulation of hypothalamic appetite regulatory centers, alteration in the gut microbiome, and reversal of consequences of aging. Metformin is also being explored in the management of obesity's sequelae such as hepatic steatosis, obstructive sleep apnea, and osteoarthritis. Multiple mechanisms underlie the weight loss-inducing and health-promoting effects of metformin. Further exploration of these pathways may be important in identifying new pharmacologic targets for obesity and other aging-associated metabolic diseases.

Keywords: Aging; Appetite regulation; Metformin; Obesity; Type 2 diabetes; Weight loss.

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Conflict of interest statement

Conflict of Interest:

Armen Yerevanian reports no conflict of interest.

Alexander Soukas reports no conflict of interest.

Figures

Figure 1.
Figure 1.
Mechanisms by which metformin impacts obesity, appetite, and weight loss. CNS: central nervous system, AgRP: Agouti-related peptide, AMPK: AMP-activated protein kinase, NTS: nucleus tractus solitarius, SCFA: short chain fatty acids, GLP-1: glucagon like peptide-1, PYY: peptide YY.
See this image and copyright information in PMC

References

    1. Witters LA, The blooming of the French lilac. J Clin Invest, 2001. 108(8): p. 1105–7. - PMC - PubMed
    1. Bailey CJ, Metformin: historical overview. Diabetologia, 2017. 60(9): p. 1566–1576. - PubMed
    1. J W.E.a.B., The preparation of methylguanidine, and of ββ-dimethylguanidine by the interaction of dicyandiamide, and methylammonium and dimethylammonium chlorides respectively. J Chem Soc Trans, 1922. 121: p. 1790–1794.
    1. DeFronzo RA and Goodman AM, Efficacy of metformin in patients with non-insulin-dependent diabetes mellitus. The Multicenter Metformin Study Group. N Engl J Med, 1995. 333(9): p. 541–9. - PubMed
    1. American Diabetes, A., Standards of Medical Care in Diabetes-2019 Abridged for Primary Care Providers . Clin Diabetes, 2019. 37(1): p. 11–34. - PMC - PubMed