Mixed
Among individuals with overweight or obesity who achieve initial weight loss (≥5%) in the first year, long-term maintenance of that weight loss (years 6-15) is significantly greater for those assigned to metformin compared to those assigned to intensive lifestyle intervention (ILS).
If you have prediabetes or are at high risk, achieving even a modest 5% weight loss in the first year is a strong predictor of long-term success. For those who achieve this, adding metformin (if prescribed) may help you keep the weight off better than lifestyle changes alone over the long haul (10+ years). It acts as a maintenance aid rather than just an initial weight loss tool.
Among persons with weight loss of at least 5% after 1 year, those originally randomly assigned to metformin had the greatest loss during years 6 to 15.
Why this rating
Based on a large, long-term (15 years) randomized controlled trial (DPP/DPPOS) with high retention, though the specific analysis is a post-hoc subset analysis.
Source
Long-Term Weight Loss With Metformin or Lifestyle Intervention in the Diabetes Prevention Program Outcomes Study
John W. Apolzan et al. · Annals of Internal Medicine · 2019
DOI 10.7326/m18-1605
Related findings · Mixed
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