Effects of metformin on energy intake and satiety in obese children

Diabetes Obes Metab. 2015 Apr;17(4):363-70. doi: 10.1111/dom.12426. Epub 2015 Jan 11.

Abstract

Aims: To investigate the effects of metformin on appetite and energy intake in obese children with hyperinsulinaemia.

Methods: We conducted a 6-month randomized, double-blind, placebo-controlled trial to evaluate the effects of metformin 1000 mg twice daily on body weight and energy balance in 100 obese children with hyperinsulinaemia aged 6-12 years. The children ate ad libitum from standardized food arrays on two separate occasions before and 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 the children 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 (metformin-treated, n = 45; placebo-treated, n = 39). Compared with placebo, metformin treatment elicited significant reductions from baseline in adjusted mean ± standard error of the mean energy intake after the pre-meal load (metformin: -104.7 ± 83.8 kcal vs. placebo: +144.2 ± 96.9 kcal; p = 0.034) independently 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) after 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 children with hyperinsulinaemia.

Trial registration: ClinicalTrials.gov NCT00005669.

Keywords: child; energy intake; insulin resistance; metformin; obesity.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Appetite Depressants / adverse effects
  • Appetite Depressants / therapeutic use*
  • Body Mass Index
  • Child
  • Child Behavior / drug effects
  • Child Nutritional Physiological Phenomena / drug effects*
  • Combined Modality Therapy / adverse effects
  • Diet, Reducing
  • Double-Blind Method
  • Energy Intake / drug effects*
  • Female
  • Humans
  • Hyperinsulinism / etiology
  • Hyperinsulinism / prevention & control
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use*
  • Life Style
  • Male
  • Metformin / adverse effects
  • Metformin / therapeutic use*
  • Motor Activity
  • National Institutes of Health (U.S.)
  • Off-Label Use
  • Parents / education
  • Patient Education as Topic
  • Pediatric Obesity / blood
  • Pediatric Obesity / drug therapy*
  • Pediatric Obesity / physiopathology
  • Pediatric Obesity / therapy
  • Satiety Response / drug effects*
  • United States
  • Weight Loss / drug effects

Substances

  • Appetite Depressants
  • Hypoglycemic Agents
  • Metformin

Associated data

  • ClinicalTrials.gov/NCT00005669