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Objectives: Metformin is the first line treatment for type 2 diabetes mellitus (T2DM) in both adults and children and has been shown to result in weight loss. Pediatric obesity is a major risk factor for the development of T2DM as well as several other diseases. Recently, physicians have reported using Metformin off-label to treat obesity in adolescent patients. The purpose of this study is to investigate whether Metformin is effective in reducing BMI in obese adolescents.
Methods: Studies were found using PubMed, MeSH, Medline, and CINAHL. The search terms used were: “obesity,” Metformin,” “adolescents,” “children,” “metformin and weight,” and “metformin and BMI.” Several studies were excluded, including meta-analysis studies, reviews, studies written in a foreign language, and studies published before 2000. Studies were also excluded if their sample populations included ages below 6 years old or above 18 years old, if they included participants with T2DM, and studies that involved other drugs besides Metformin. The final 3 studies were chosen based on their relevance to our clinical question.
Results: The first study showed a significant reduction in BMI z score of 0.8 +/-0.2 in prepubertal children, and a nonsignificant reduction of 0.4+/-0.2 in pubertal children. Study 2 showed a significant reduction in BMI-SDS from 3.44 (SD 0.57) to 3.35 (SD 0.65). In Study 3, BMI-SDS was significantly higher in the metformin group compared to the lifestyle intervention group. After 12 months of treatment, this difference disappeared. However, the change in BMI-SDS between the metformin group and lifestyle intervention group in Study 3 was not significant.
Conclusion: Further studies need to be done to determine the role of metformin in treating obese, non-diabetic adolescents. While current studies suggest some benefit of metformin in childhood obesity, sample sizes are relatively low, and results vary between prepubertal and pubertal children. However, our research did show a decrease in standardized BMI in obese pediatric patients receiving metformin, indicating a possible role of metformin in treating adolescent obesity.
Mcnamee, M., Eggen, V., Effect of Metformin on Adolescent Obesity. 2019