How Metformin Is Shown to Cause Weight Loss

Here’s what we’ll cover in this blog post:

  • How long to take high doses
  • When to wean your dose down
  • How to maximize weight loss benefits
  • What to do if you don’t hit your goals

Metformin is a popular medication both for diabetes management and for boosting your longevity. Recently, Metformin has also been gaining popularity for another longevity benefit: healthy weight loss up to 5% of body weight over 6-12 months.

At the 12 month mark, your prescriber will titrate down your dosage. Some of our patients ask us, why can’t you stay on the higher weight loss dosage of Metformin after 12 months? How do you reduce your dose after hitting your goals, and how can I maximize the benefits of my weight loss?

When it comes to Metformin and long-term weight maintenance, there are some careful strategies to consider to help you get the most from each dose. Whether you’ve just started Metformin for weight loss, or you’ve reached your first 12 months, here’s everything you need to know to achieve the best results.

Why Aren’t Higher  Metformin Doses a Long-Term Strategy?

At these doses, the risk of side effects becomes much higher when administered for more than 12 months, which some patients may find intolerable. This is especially true when it comes to B12 deficiency kidney conditions. If you’re taking 2,250mg of Metformin, you should consider regular blood tests to ensure that your risk of B12 deficiency and kidney conditions remains low.

Gastrointestinal side effects, even at high doses, often go away on their own as your body adjusts to the medication. These side effects normally resolve within 2-6 weeks, but they may come back when you increase your dose. Side effects may also take longer to resolve at higher doses.

However, Metformin is a major factor for B12 deficiency when taken at high doses. While regular B12 supplementation may decrease your risk of B12 deficiency and related conditions like anemia, this may not always be the case.

Metformin may also increase your risk of kidney issues like lactic acidosis. This risk increases for patients over 65 or with pre-existing kidney dysfunction. Though this is a rare side effect, your prescriber may recommend alternative strategies if you fall into these categories. Metformin circulates through the kidneys, which means long-term use of higher doses of Metformin may slightly increase this risk.

For these reasons, prescribers typically reserve long-term Metformin regimens of 2,000mg or higher for patients with long-term conditions like diabetes or polycystic ovary syndrome (PCOS).  Patients who don’t have diabetes or PCOS shouldn’t sustain these doses for more than 12 months. 

Fortunately, when it comes to Metformin and long-term weight maintenance, you may not need to take higher doses of Metformin for longer than 12 months.

How to Reduce Your Dose After 12 Months

Once you’ve hit 12 months in your titration, you will wean down to a dose of 1,500mg per day. You can do this starting from your first refill on month 13 of your prescription.

To wean down, all you need to do is reduce your dose to two 750mg tablets. This will be your new dose for the remainder of your prescription, or until your prescriber recommends a different dose.

Titrating down to 1,500mg per day is a safe way to reduce your risk of side effects while maintaining your weight loss results. By this point you may have lost about 5-7% of your body weight, which is near the maximum expected for Metformin and long-term weight maintenance.

If you haven’t reached maximum weight loss or achieved your desired results, taking 1,500mg of Metformin may still help encourage additional weight loss.

 What Should I Do If I Haven’t Reached My Target Weight?

For the best results, you should maintain regular exercise and a healthy diet while taking Metformin. Exercise can help maximize the potential weight loss benefits, while a healthy diet may reduce the risk or severity of potential side effects. 

If you still haven’t reached your expected weight loss results, even with diet and exercise, consider scheduling a longevity consultation with an AgelessRx prescriber. This way, your prescriber can consider your unique health history against your longevity needs and recommend better solutions.

One solution to consider is a GLP-1 medication like Wegovy, which contains the active ingredient Semaglutide. Wegovy is FDA approved for weight loss in adults with a BMI of 27 or more, and has shown up to 20% weight loss in clinical trials. When taken with Metformin, Wegovy may help you break through your weight loss plateau.

Other medications may also increase potential weight loss when combined with Metformin. But you should always contact your prescriber before considering any additional medications.

Achieving and maintaining a healthy weight is a key component of longevity, and your longevity is our main goal. Healthy weight can reduce the risk of chronic diseases and improve overall well-being. Tailoring your weight loss plan to your unique health needs will support not only your weight goals, but also your overall vitality, so you can enjoy a better quality of life and spend more time in good health.


Note: The above statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.