Metformin Helps Women With Midlife Weight Gain

0 Comments | Family Practice News, August 1, 2000 | by Bruce Jancin

TORONTO -- Metformin may be an effective tool for long-term weight loss in nondiabetic women with midlife weight gain and hyperinsulinemia, Dr. Harriette R. Mogul said at the annual meeting of the Endocrine Society.

The drug has a synergistic effect when combined with moderate dietary carbohydrate modification, added Dr. Mogul of New York Medical College, Valhalla, N.Y

She reported on the use of metformin at a mean daily dosage of 1,500 mg in combination with dietary modification in 26 consecutive menopausal women with midlife weight gain. Eighteen of the women were classified as overweight to mildly obese, with a body mass index of 25-32.9 kg/[m.sup.2]; the remainder had body mass indexes of 33-37 kg/[m.sup.2].

All had normal blood sugars but were hyperinsulinemic. All had failed to lose weight despite regularly engaging in more than three exercise sessions per week along with self-reported prior attempts at dieting. The women went on a calorie-restricted diet of 1,200-1,600 calories/day plus four American Diabetes As-sociation fat exchanges and an equal number of carbohydrate exchanges per day, along with elimination of added sweets.

The 18 overweight women lost a mean of 16.5 pounds at 6 months' follow-up and 19.2 pounds at 12 months; the 8 obese women lost a mean of 23.8 pounds at 6 months and 33.2 pounds at 12 months. Twenty-four of the 26 women lost a mean of 15% of their baseline weight.

Follow-up out to 2 years was available in 22 of the 24 good responders at t year. Seven continued progressing toward their goal weight. Ten women who reached their goal rate during year 1 continued on metformin in year 2 and maintained their goal weight. Five women discontinued metformin in year 2 after reaching their goal weight; four of the five regained at least 10 pounds or more than 50% of their lost weight within 3 months.

Metformin, which has been used in Europe to treat obesity in nondiabetic patients with good success, is just now starting to come under scrutiny as an obesity therapy in the United States.

The drug-and-diet program was easily implemented with minimal physician contact, and the effects were long lasting. Because undetected insulin abnormalities are extremely common in overweight adults, this therapy has potentially widespread applicability, Dr. Mogul said.