Among them, diet pills are one of them, and metformin is famous and hyped up, and it is moving towards the "altar". What works well and has no side effects? It makes you thin once you eat it.
Let's talk about it today. What is metformin? How big is the role of losing weight? Want to eat metformin to lose weight, can you have side effects?
In a word, is it effective?
Metformin is actually a hypoglycemic agent for diabetic patients, and it is the most widely used hypoglycemic agent in clinic. It is widely used because of its low price, good hypoglycemic effect and small side effects. Many patients with primary diabetes may not have used other drugs, but they must have (almost) taken metformin.
First, there are few gastrointestinal reactions, including diarrhea, nausea, vomiting, abdominal distension and fatigue. But at present, this side effect is temporary and can be relieved by itself.
That is to say, if patients can tolerate short-term discomfort and take medicine for more than 10 weeks, this side effect will disappear, and finally most patients can tolerate it. In clinical trials in the United States, only 4% of the subjects could not continue to use metformin because of adverse reactions [1].
(It is mentioned here that if diabetic patients reduce adverse reactions, they can start with a small dose, gradually increase the dose, and adjust the dose in a timely manner. Non-metformin sustained-release preparation can be taken with meals in several times, or it can be changed to metformin sustained-release preparation taken once a day. )
Serious side effects are rare, only lactic acidosis. Moreover, it will only happen if the patient has kidney and liver-related diseases, so most people don't have to worry.
Second, unlike other hypoglycemic drugs, metformin only reduces hyperglycemia, which will not affect normal blood sugar and will not cause hypoglycemia. This is actually very rare, because many hyperglycemia drugs are not well controlled. Once hypoglycemia occurs, the patient may tremble, have a rapid heartbeat, be hungry, sweat profusely, feel weak in limbs, have a headache, etc. It may be life-threatening in severe cases.
The key is that the key to blood sugar is stability. This blood sugar fluctuation is actually very bad. The greater the blood sugar fluctuation of diabetic patients, the greater the risk of complications.
This is because blood sugar fluctuation is also a kind of stress to the body, which will bring a series of adverse consequences, such as macroangiopathy and microangiopathy.
Moreover, the indications of metformin drugs are still expanding, including lipid-lowering, anti-tumor and prevention of cardiovascular complications. Including the unproven weight loss effect, but many people have bought it.
First of all, metformin has not been found to have a weight loss effect on normal people.
Where did the rumor that metformin can lose weight come from?
Metformin is suitable for obese patients with diabetes.
Because metformin can improve the insulin sensitivity of peripheral tissues by reducing the output of hepatic glycogen, it can reduce HbA 1c 1.0% 1.5%, and at the same time, it can reduce the average body weight by about 1. 1kg. [ 1]
Another study found that metformin can also reduce weight for people with pre-diabetes (that is, although their blood sugar is higher than the normal range, but it does not reach the threshold of diabetes):
In 20 12, the American medical association published a study on this, and the results were followed up for 10 years. The final conclusion is that metformin can lose weight, and the subjects can lose weight after taking 1 2 years, and can lose 2.1kg after taking medicine for 3 years. On average. After taking 10 years, the metformin group lost 2.5kg on average. The main adverse reaction was gastrointestinal reaction, and the incidence rate was the same as that of the control group over time. No major safety accidents, good tolerance [2].
However, the final weight loss effect is related to medication compliance. Medication compliance is a relatively academic concept. To put it simply, did you take the medicine on time and according to the doctor's advice? In this experiment, it means whether you take metformin 1.2 times a day, and whether you eat enough each time.
From the experimental chart, we can also see that the higher the medication compliance, the better the weight loss effect.
How does metformin lose weight?
One is to change the insulin sensitivity mentioned above:
Second, it may be due to the adverse reaction of metformin:
This goes back to the original case—
Miss Zeng in the case lost weight after eating metformin-in fact, she was hungry! Later, I endured the adverse reaction of metformin and my diet returned to normal, so I ... bounced back. .
First of all, Dr. Ayuan here does not recommend that healthy people take metformin to lose weight, or take medicine to lose weight simply for cosmetic needs.
For obese patients who need to take metformin, it is also necessary to understand the "contraindications" of metformin (that is, things that must not be done during medication)
If there are these situations, you can't eat metformin [2]
Metformin also interacts with other drugs:
Long-term use of metformin will lead to vitamin B 12 deficiency and megaloblastic anemia. At present, it is suggested that patients who have been using metformin for a long time should measure the level of 1 vitamin B 12 every year, and supplement vitamin B 12 according to the assessment of their illness and the need.
To sum up, metformin, a hypoglycemic agent with specific indications, has a slimming effect on special people and has become the first choice for patients with diabetes complicated with obesity. [ 1]
But it is not the "magic medicine" that many people expect to lose weight-
First, it can be seen from the study that the weight loss effect of metformin is not outstanding;
Second, metformin needs long-term use. The more you insist on taking according to the course of treatment, the greater the effect may be. However, many people who take diet pills expect short-term results. It seems that metformin is difficult to meet their expectations.
Third, taking metformin will cause gastrointestinal adverse reactions in the short term.
Dr. Ayuan, a popular scientist, said many times before that the core of weight loss always lies in energy difference. It is very difficult to lose weight by eating less or exercising more, but unfortunately, so far, human beings have not found a shortcut.
References:
Li Yan Zeng Tingting. Comprehensive treatment of overweight/obesity with diabetes in adults. Clinical internal medicine magazine. 2020； 9(37):607-6 10.
[2] Research Group of Diabetes Prevention Program. Long-term safety, tolerance and weight loss related to metformin in the results study of diabetes prevention program. Diabetes care. 20 12; 35(4):73 1-737.
Mu, Ji Linong, et al. Expert knowledge of clinical application of metformin (version 20 16) [J]. Natural enemies of diabetes: clinical, 2016,24 (10): 871-87.