Sulfonylureas like glipizide Sulfonylureas are another common group of diabetes medications that can cause weight gain. They work by stimulating the pancreas to release insulin. Remember, more insulin in the body means more insulin is available to turn blood glucose into fat.
Another common class of diabetes medication, sulfonylureas, reduce blood sugar levels by 20 percent but also cause a weight gain of about four to five pounds on average, notes a study published August 2015 in the Archives of Medical Science. Sulfonylureas include gliclazide (Diamicron) and glibenclamide (Glynase).
This in turn lowers blood sugar levels. Metformin has two advantages over other diabetes drugs: There's less risk of your blood sugar level falling too low. It doesn't cause weight gain.
Some foods can help you to gain weight without causing big rises in your blood glucose (sugar) levels. These include foods high in: Protein, such as meat, fish, chicken, legumes, eggs, nuts and full-cream dairy foods. Energy, such as margarine, avocado, nut butters, oil and salad dressing.
Under certain conditions, too much metformin can cause lactic acidosis. The symptoms of lactic acidosis are severe and quick to appear, and usually occur when other health problems not related to the medicine are present and are very severe, such as a heart attack or kidney failure.
One is that the medication can reduce your appetite. This is because metformin increases the body's sensitivity to hormones such as insulin and leptin. Leptin is in charge of telling your body when it is full and should stop eating, so increased sensitivity to this hormone can result in you feeling less hungry.
These injectable drugs include dulaglutide (Trulicity), liraglutide (Victoza), and semaglutide (Ozempic); the latter is also available as a pill called Rybelsus. Liraglutide and semaglutide are also approved for weight loss, in formulations marketed respectively as Saxenda and Wegovy.
Two GLP-1 medications are currently approved for weight loss: Liraglutide (Saxenda) and semaglutide (Wegovy). Both medications are approved for long-term use. Some other GLP-1 drugs like Ozempic are approved for diabetes, but do not have full approval for weight-loss use.
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But Ozempic's rise to superstardom status was not something most people predicted. In fact, the drug was created by Novo Nordisk to help diabetes patients control their blood sugar.
Mounjaro (tirzepatide), Ozempic (semaglutide), and Trulicity (dulaglutide) are examples of diabetes medications that can cause significant weight loss. Metformin and Jardiance (empagliflozin) may also cause weight loss but not as much.
If you eat a lot of sugar while taking Metformin, your body will have to work harder to keep your blood sugar levels within a healthy range, and the Metformin will not be as effective for weight loss. However, if it happens infrequently, you should not suffer too many negative side effects. The key is moderation.
One long term study published in 2019 found that 28.5% of those taking metformin lost about 5% or less of their body weight during the first year. And those who lost weight on metformin during the first year had the greatest success with weight loss during years 6-15 (15).
Medicines containing guanidine, such as metformin and phenformin, were developed to treat diabetes. But they fell out of favor due to serious side effects caused by phenformin, and by the discovery of insulin.
Taking certain selective serotonin reuptake inhibitors (SSRIs) such as Paxil, Prozac (fluoxetine) or Zoloft (sertraline) makes you more prone to gaining weight. Another class of antidepressant medications known as tricyclic antidepressants (TCAs) increase your appetite and cause you to gain those unwanted pounds.
The bottom line
Certain diabetes medications, antidepressants, and antipsychotics are common culprits. Steroids, the birth control shot, and some beta blockers can also cause weight gain. Lifestyle changes, like diet and exercise, may be helpful in managing this side effect.
Metformin, an oral type 2 diabetes medicine, may lead to a modest weight loss and does not usually lead to significant, if any, weight gain. In various clinical studies, when metformin was used alone, it led to a weight loss of 0.7 to 3.8 kg (1.5 to 8.4 lbs) in patients.
Alcohol: Metformin interacts with alcohol, so avoid binge drinking or regular alcohol intake when on the medication.
Metformin may have an adverse effect on renal function in patients with type 2 DM and moderate CKD.
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