Effects of Metformin on Energy Intake and Satiety in Obese Children

Mopelola A. Adeyemo MPH, et al.

Aims
Metformin's ability to promote weight loss is believed to be at least partly attributable to decreased energy consumption. There are few data regarding the effects of metformin on energy intake in children. We therefore investigated metformin's effects on appetite and energy intake in obese hyperinsulinemic children.

Materials and Methods
We conducted a 6-month randomized, double-blind, placebo-controlled trial to evaluate the effects of metformin 1000mg BID on body weight and energy balance in 100 obese hyperinsulinemic children aged 6-12y. Subjects ate ad libitum from standardized food arrays on two separate occasions before, and then again after, 6 months of study medication. The first test meal was consumed after an overnight fast. The second was preceded by a pre-meal load. For each test meal, energy intake was recorded, and subjects completed scales of hunger, fullness, and desire to eat.

Results
Data from the meal studies at baseline and after treatment with study medication were available for 84 children (45 metformin-treated and 39 placebo-treated). Compared with placebo, metformin treatment elicited significant reductions from baseline in adjusted mean energy intake after the pre-meal load (metformin: 104.7±83.8kcal vs. placebo: +144.2±96.9kcal; p?=0.034) independent of changes in body composition. Metformin also significantly decreased ratings of hunger (1.5±5.6 vs. +18.6±6.3; p=0.013) and increased ratings of fullness (+10.1±6.2 vs. -12.8±7.0; p?=0.01) following the pre-meal load.

Conclusions
These data suggest that decreased perceived hunger resulting in diminished food intake are among the mechanisms by which metformin treatment reduces body weight in overweight, hyperinsulinemic children.

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