If metformin suppresses blood glucose, how does it affect how eating food reduces appetite?

[Alex K Chen]

Also I'm starting to take 850mg metformin per day and wonder when is the best time for me to time it...

[TomBAvoider]

All you ever do, is ask questions. Which, fine. But. It would be nice if your questions were at least grammatically coherent. What in the world does this question mean:

 

"If metformin suppresses blood glucose, how does it affect how eating food reduces appetite?"

 

I honestly have no idea what this completely incoherent question means. Is English your native tongue? Eating food reduces appetite? Metformin is supposed to affect how food reduces appetite, because metformin suppresses blood glucose? This makes zero sense. Good Lord, man, slow down and think through what you are asking, and then write sentences in idiomatic English. Usually you just throw drive by questions onto the board and disappear, so I have no idea if you'll even come around to clarify this mess. The second question:
 

"Also I'm starting to take 850mg metformin per day and wonder when is the best time for me to time it..."

 

is also not clear, but at least one can try to guess what it means - are you asking what time is the best time to take metformin? Or are you asking, as your question reads right now, that you are asking what the best time is to time your intake of metformin - as in timed release or immediate release? Again, slow down, take a deep breath, and try to write questions that can at least be understood.

[Sibiriak]

TomBAvoider:  Eating food reduces appetite?

 

Eating food usually reduces one's appetite  for food.   Foods differ, of course, in their ability to produce satiety.

 

Metformin is supposed to affect how food reduces appetite, because metformin suppresses blood glucose?

 

I  haven't done much reading about about metformin, since it's not something I personally would  consider taking, but the question of metformin's effect on appetite is not an uninteresting one.

 

Effects of metformin on weight loss: potential mechanisms.

Curr Opin Endocrinol Diabetes Obes. 2014 Oct;21(5):323-9. doi: 10.1097/MED.0000000000000095.

Malin SK¹, Kashyap SR.   PMID:25105996

 

https://www.ncbi.nlm.nih.gov/pubmed/25105996

 

Abstract

PURPOSE OF REVIEW:

Despite the known glucose-lowering effects of metformin, more recent clinical interest lies in its potential as a weight loss drug. Herein, we discuss the potential mechanisms by which metformin decreases appetite and opposes unfavorable fat storage in peripheral tissues.

 

RECENT FINDINGS:

Many individuals struggle to maintain clinically relevant weight loss from lifestyle and bariatric surgery interventions. Long-term follow-up from the Diabetes Prevention Program demonstrates that metformin produces durable weight loss, and decreased food intake by metformin is the primary weight loss mechanism.

 

Although the effect of metformin on appetite is likely to be multifactorial, changes in hypothalamic physiology, including leptin and insulin sensitivity, have been documented. In addition, novel work in obesity highlights the gastrointestinal physiology and circadian rhythm changes by metformin as not only affecting food intake, but also the regulation of fat oxidation and storage in liver, skeletal muscle, and adipose tissue.

 

SUMMARY:

Metformin induces modest weight loss in overweight and obese individuals at risk for diabetes. A more detailed understanding of how metformin induces weight loss will likely lead to optimal co-prescription of lifestyle modification with pharmacology for the treatment of obesity independent of diabetes.

 

 

 

Long-Term Safety, Tolerability, and Weight Loss Associated With Metformin in the Diabetes Prevention Program Outcomes Study

 

Diabetes Care. 2012 Apr; 35(4): 731–737.

PMCID: PMC3308305

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3308305/

 

 

Metformin lowers glucose and reduces risk for diabetes in part through weight loss (2,7,16,17). Although basal energy metabolism is highly correlated with body mass, early studies showed that despite appreciable reductions in body weight with metformin treatment, basal energy expenditure remains unchanged (18). This is because metformin-induced weight loss is almost exclusively confined to reductions in adipose mass (2,16,18) with little change in lean tissue.

 

This pattern is different from that seen with caloric restriction, which tends to induce loss of lean tissue as well as adipose tissue. Metformin has several effects on energy metabolism that parallel physical exercise. Both exercise and metformin stimulate phosphorylation of AMP-activated protein kinase (AMPK) (19). AMPK is an important regulator of mitochondrial biogenesis (20), hepatic and muscle fatty acid oxidation, glucose transport, insulin secretion, and lipogenesis (21). Whether metformin directly affects energy expenditure from physical activity is unknown. Metformin might also influence weight loss through reduced food intake owing to irritation of the gastrointestinal tract, which may motivate a reduction in food intake or change in nutritional preference.

[TomBAvoider]

Right. But the question from the OP is not - at least as written - about how metformin affects appetite, but "how does metformin affect how eating food reduces appetite". One can speculate that the OP meant "how does metformin affect appetite", but that's not how the question is phrased. That is why I asked that the OP clarify what he means, because as written it's impossible to be sure. But that's the OP's SOP - he asks a hard to understand question, and then rarely comes back to answer any followup.