Will I Lose Weight On Metformin For Pcos

It's Not Recommended | Band-Aid Solution | Weight Loss | Fertility | Depletes Nutrients | Side Effects | Alternatives | Bottom Line | FAQ

Metformin is one of the most commonly prescribed treatments for PCOS. But it shouldn’t be. In this article, I describe the failures and shortcomings of metformin for PCOS. I also describe better alternatives. Chief among them are dietary interventions.

This is an evidence-driven perspective. But you can see how the consequences play out among women that take part in my free 30-Day PCOS Diet Challenge.

Metformin Weight Loss Pcos: Benefits And Risks In 2023

Experts recommend against the use of metformin for PCOS without diabetes. Even if you have glucose intolerance and are prediabetic. It’s only supposed to be for patients with type 2 diabetes.

In 2003, Dr. Robert Barbieri authored a guide on the use of metformin therapy to treat PCOS [1]. Many prescribing physicians may still rely on this guidance.

But, by 2018, Barberi and his colleagues had changed their recommendations. Based on more recent data, they no longer recommend the use of metformin as a first-line therapy for, “any indication” [2].

Can Metformin Help With Weight Loss?

Metformin is a band-aid solution for preventing diabetes. The same is true in the treatment of PCOS. It only lowers your insulin levels as long as you’re taking it daily.

In 2002, the Diabetes Prevention Program Research Group quantified these benefits. They found that over 3 years, metformin reduced the incidence of newly developed diabetes cases by 31% [3]. But in a follow-up study, the majority of the benefit didn’t persist when the treatment was stopped [4]. This means that unless you make other changes, you’ll need to take metformin for life.

The same researchers compared metformin to a diet and lifestyle intervention. Their “lifestyle group” enrolled in a 24-week program focusing on diet and exercise. This group reduced their risk of type 2 diabetes by 58% [3]. This was significantly better than the 31% achieved by the metformin group. After 15 years, the lifestyle program still proved to be better than metformin at preventing diabetes [5]. For women in this study, the lifestyle program was also better at reducing microvascular complications.

Metformin With Pcos: How It Can Help You Manage Your Symptoms And Shed Belly Fat?

This supports what I see within my PCOS support group. Many women that take part in my free 30-Day PCOS Diet Challenge take metformin. For those that can adapt to a PCOS diet, their insulin sensitivity improves dramatically. Over time, many of these women get key biomarkers back within normal ranges and stop taking this unnecessary drug.

Many women are told that metformin helps with weight loss. That’s why “metformin PCOS weight loss” and “PCOS belly fat metformin” are such heavily searched terms on Google. A quick look at the scientific literature though shows that any weight loss benefits of metformin for PCOS are small at best.

Metformin can cause weight loss in non-diabetic people. In one study, people with severe insulin resistance lost more weight than insulin-sensitive people [6]. These benefits were independent of age, sex, and BMI. But the results are different for women with PCOS.

Ways To Lose Weight With Pcos

In a 2017 meta-analysis, Morely and colleagues reviewed 42 metformin studies in women with PCOS. They found that metformin had a slight improvement in the distribution of excess body fat. This led to a small improvement in waist to hip ratio. But there was no effect on body weight [7].

Meta-analyses like these are the most powerful assessments of scientific evidence. Smaller (and older) metformin weight loss PCOS studies have shown a slight benefit [8]. But the size of the effect was small. When considering the entire body of evidence, metformin is unlikely to help you lose weight.

The impact of dietary change overshadows any potential gains. This is because managing your diet is the best way to reverse insulin resistance. The right diet can also address chronic inflammation. This is another underlying mechanism driving PCOS weight gain. You can see this at play when PCOS women lose weight during my free 30-Day PCOS Diet Challenge. Many of their other symptoms go away too.

Pcos Belly Fat

Metformin is often used for treating anovulatory infertility in women with PCOS. It’s really common and I include myself in this cohort.

But the benefits of metformin for fertility are unclear. A 2019 review investigated the effectiveness of metformin for fertility treatment in women with PCOS. They found that for a live birth rate of 19% with no treatment, adding metformin could raise this rate by 0 to 18% [9]. This large range reflects the paucity of good data. It means that metformin therapy on it’s could have no benefit at all for fertility.

The potential benefits also seem to depend on your body weight. The quality of evidence is poor on this point too. But it appears that metformin is more likely to help non-obese PCOS women than those that are overweight [9].

F/22/5'2” [163 >136=27lbs] (6 Months ) I Finally Fixed My Pcos And Lost Weight As Easy As Never Before!

These statements would be more definitive if metformin improved PCOS infertility in a meaningful way. Given the alternatives, it’s likely that metformin will be seldom used for fertility treatment in the future.

The women from my PCOS community provide powerful testimony to the use of diet over metformin. Here are some examples from my free 30-Day PCOS Diet Challenge.

A study on older adults found that metformin use was the best predictor of vitamin B12 deficiency [11]. The larger the dose and the longer you use metformin, the lower your serum B12 levels are likely to be [12, 13]. This is because metformin impairs B12 absorption [14-18]. Given the importance of B12, this is bad news for women with PCOS. A sub-clinical deficiency can affect pregnancy outcomes, vascular, cognitive, bone, and eye health [19, 20].

The Facts About Metformin For Pcos — Pcos Living

Metformin can also affect other vitamins and minerals. This includes vitamin B1, folic acid, vitamin D, and magnesium [21]. Nutrient supplements may be required especially if you’re trying to conceive.

Learn more about the importance of magnesium for PCOS here. This article on vitamin D for PCOS explains why this nutrient, in particular, should be at the top of the list for most people.

In one study, approximately 88% of people experienced metformin side effects [22]. The most common side effects include diarrhea, heartburn, nausea, abdominal pain, bloating, and retching [23].

Why It's So Hard To Lose Weight With Pcos

When I polled my PCOS support Facebook group, 78% reported adverse effects. If you’re looking for metformin for PCOS reviews, here’s what some of the respondents said.

“the metformin I started taking for fertility made me bleed for over 20 days and I had to go to urgent care due to anemia.”

Metformin also has other less common side effects. Lactic acidosis is a rare but serious side effect [24]. There have been many case studies of metformin causing liver injury [25-27]. Studies on rats also suggest an increased risk of Alzheimer’s disease [28].

Raynetta's Pcos Weight Loss Success Story

Inositol supplements show the most promise for PCOS. For example, inositol supplements are more effective than metformin at improving menstrual frequency [29].

A 2019 meta-analysis compared the insulin-sensitizing effects of myo-inositol and metformin. Again, myo-inositol was found to be as good as metformin. Myo-inositol also performed as well as metformin when it came to improving testosterone levels, body mass index, and more [30].

One argument in favor of metformin use is for reducing the risk of ovarian hyperstimulation syndrome during IVF [31]. But inositol supplements also offer this protection [32, 33].

Metformin For Weight Loss In Pcos

The natural herb, berberine, also shows great potential in patients with PCOS. Trials show that it can improve insulin resistance, blood lipids, and ovulation [34-37]. Meta-analysis suggests that berberine is as effective as metformin for improving insulin sensitivity [38].

Like inositol supplements, berberine is generally well-tolerated. This means fewer side effects and less disruption to your everyday life. It’s important to keep in mind though, that berberine is not safe during pregnancy.

Metformin was first approved for us in 1994. This was back when PCOS was known as polycystic ovarian disease. Since then, many other insulin-sensitizing drugs have come to market. New treatments like Ozempic, Wegovy, and Mounjaro may be suitable alternatives. Especially for patients that can’t tolerate the side effects of metformin.

Is It Possible To Lose Weight With Metformin?

Of course, the best alternative to metformin for PCOS is changing how you eat. Metformin’s health benefits come from its anti-inflammatory and antioxidant properties [39]. Its alteration of the gut microbiome is also key to its effectiveness [40-42]. Both of these mechanisms depend on your diet.

A PCOS diet reduces inflammation and improves gut health. It can also reverse insulin resistance. By addressing the underlying causes of PCOS, the right diet can displace the need for metformin. It also improves other PCOS symptoms at the same time.

It’s hard to justify metformin treatment for PCOS. Experts in the field no longer recommend its use as a first-line therapy for PCOS patients. Even for PCOS women with diabetes, metformin is a band-aid solution with better alternatives.

Metformin During Pregnancy: Is It Safe To Take?

Metformin doesn’t provide meaningful weight loss results. Its cost/benefit as a fertility treatment is also tenuous given the alternatives. Metformin depletes important nutrients and has significant side effects. Ovasitol and berberine perform just as well but are much better tolerated.

A PCOS diet is the most important step for improving insulin regulation and fertility. A PCOS diet can displace the need for metformin and can further improve other PCOS symptoms.

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Is Ozempic A Promising Treatment For Insulin Resistance And Pcos?