Hormonal
Long-term metformin treatment (1700 mg/day) combined with a hypocaloric diet significantly reduces visceral adipose tissue (VAT) and body weight in abdominally obese women with PCOS compared to placebo, with effects on VAT being significantly greater in PCOS patients than in obese controls without PCOS.
For abdominally obese women with PCOS, adding metformin (1700 mg/day) to a standard hypocaloric diet (1200-1400 kcal) is more effective for reducing visceral fat and body weight than diet alone. This benefit appears specific to those with PCOS, suggesting that addressing insulin resistance is key to targeting visceral fat in this population. Side effects are generally mild and transient.
Metformin treatment significantly decreased SAT values in both PCOS and control groups, although only in the latter group were SAT changes significantly greater than those observed during the placebo treatment. On the contrary, visceral adipose tissue area values significantly decreased during metformin treatment in both PCOS and control groups, but only in the former was the effect of metformin treatment significantly higher than that of placebo.
Why this rating
Randomized, double-blind, placebo-controlled trial with a relatively small sample size (n=35 final analysis) but rigorous CT scanning for body composition.
Source
Effect of Long-Term Treatment with Metformin Added to Hypocaloric Diet on Body Composition, Fat Distribution, and Androgen and Insulin Levels in Abdominally Obese Women with and without the Polycystic Ovary Syndrome
Renato Pasquali et al. · The Journal of Clinical Endocrinology & Metabolism · 2000
DOI 10.1210/jcem.85.8.6738
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