Study: Metformin and Carbohydrate-Modified Diet May Help Sustain Weight Loss

Title: Metformin and Carbohydrate-Modified Diet May Help Sustain Weight Loss
URL: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=R
Retrieve&db=PubMed&dopt=Abstract&list_uids=1463332 1
Heart Dis 2003 Nov-Dec;5:6:384-92. "Long-term (2-4 year) weight
reduction with metformin plus carbohydrate-modified diet in euglycemic,
hyperinsulinemic, midlife women (syndrome w)"
12/16/2003 01:49:00 PM
By Jill Taylor


The combined regimen of metformin and a carbohydrate-modified diet
promotes long-term weight stabilisation in obese, middle-aged, nondiabetic
women with documented insulin abnormalities, say American researchers. The
majority of patients who successfully lose weight in traditional dietary
programs regain the weight within 2 to 4 years, and few treatment strategies
for sustained weight reduction exist that are effective, safe, and
acceptable. In a previous study, women with Syndrome W, an early variant of
the Metabolic Syndrome, achieved significant weight loss with metformin and
a carbohydreate-modified, hypocaloric, low-glycaemic-index diet. To assess
the long-term efficacy this regimen, Harriette R Mogul, MD, MPH, and
colleagues of New York Medical College, Valhalla, United States, conducted a
retrospective analysis of 21 study participants who returned for medication
renewal and annual surveillance visits. All patients included in the
analysis had achieved a 1-year weight loss of more than 10% or body mass
index (BMI) normalisation. Baseline characteristics included an average age
of 55.2 years, BMI of 34.2 kg/m[2, and weight of 196.9 lbs. The researchers
observed weight maintenance at the final (2 to 4 years) follow-up visit in
90.5% of the women, with the mean weight at final follow-up highly
correlated with mean weight at 1-year protocol completion. Furthermore, a
significant and robust decline in fasting insulin (-27.5% -43.8%, P .002)
was observed at all follow-up visits. Metformin was well tolerated, without
reported side effects or electrolyte imbalance. Although researchers
acknowledge clear methodologic limitation, they hope that the study findings
will encourage clinicians to contemplate the potential viability of defining
and treating insulin abnormalities in euglycemic women with midlife weight
gain who fail to respond to other obesity interventions. "We believe this
effective novel obesity treatment, which is easily implemented in a clinical
setting, could have important implications for women with Syndrome W, and
quite possibly for other subpopulations of obese nondiabetic Americans with
progressive weight gain and documented hyperinsulinemia," they conclude.



http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=R
Retrieve&db=PubMed&dopt=Abstract&list_uids=1463332 1

Roger,

Of course, what the article fails to report is that a "carbohydrate modified
diet" _without_ metformin will also produce long term weight loss for middle
aged ladies too. g

Metformin should only be considered after you've stalled for a long time
while eating a controlled calorie, low carb diet., or when a low carb diet
is not controlling diabetic blood sugar, or if you have have been diagnosed
with PCOS.

It's pretty nasty stuff, producing extremely unpleasant digestive problems
in some people and a potentially fatal condition, lactic acidosis, in
others.

I tried it after my 3 year stall only to find that it caused two disturbing
side effects. One, which is rare, is that it caused me to have intense
reactive low blood sugar attacks which made me faint and dizzy (my blood
sugar dropped into the low 60s after every meal after a few months on it.)
The other was that it gave me wierd cramps in my upper left chest that felt
like I was having a heart attack. The endocrinologist told me that was a
"known effect."


-- Jenny
Cut the carbs to respond to my email address!

Low carb facts and figures, my weight-loss photos, tips, recipes and more at
http://www.geocities.com/jenny_the_bean/

Looking for help controlling your blood sugar?
Visit http://www.alt-support-diabetes.org/...0Diagnosed.htm



"Roger Zoul" wrote in message
...
Title: Metformin and Carbohydrate-Modified Diet May Help Sustain Weight
Loss
URL: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=R
Retrieve&db=PubMed&dopt=Abstract&list_uids=1463332 1
Heart Dis 2003 Nov-Dec;5:6:384-92. "Long-term (2-4 year) weight
reduction with metformin plus carbohydrate-modified diet in euglycemic,
hyperinsulinemic, midlife women (syndrome w)"
12/16/2003 01:49:00 PM
By Jill Taylor


The combined regimen of metformin and a carbohydrate-modified diet
promotes long-term weight stabilisation in obese, middle-aged, nondiabetic
women with documented insulin abnormalities, say American researchers. The
majority of patients who successfully lose weight in traditional dietary
programs regain the weight within 2 to 4 years, and few treatment
strategies
for sustained weight reduction exist that are effective, safe, and
acceptable. In a previous study, women with Syndrome W, an early variant
of
the Metabolic Syndrome, achieved significant weight loss with metformin
and
a carbohydreate-modified, hypocaloric, low-glycaemic-index diet. To assess
the long-term efficacy this regimen, Harriette R Mogul, MD, MPH, and
colleagues of New York Medical College, Valhalla, United States, conducted
a
retrospective analysis of 21 study participants who returned for
medication
renewal and annual surveillance visits. All patients included in the
analysis had achieved a 1-year weight loss of more than 10% or body mass
index (BMI) normalisation. Baseline characteristics included an average
age
of 55.2 years, BMI of 34.2 kg/m[2, and weight of 196.9 lbs. The
researchers
observed weight maintenance at the final (2 to 4 years) follow-up visit in
90.5% of the women, with the mean weight at final follow-up highly
correlated with mean weight at 1-year protocol completion. Furthermore, a
significant and robust decline in fasting insulin (-27.5% -43.8%, P
..002)
was observed at all follow-up visits. Metformin was well tolerated,
without
reported side effects or electrolyte imbalance. Although researchers
acknowledge clear methodologic limitation, they hope that the study
findings
will encourage clinicians to contemplate the potential viability of
defining
and treating insulin abnormalities in euglycemic women with midlife weight
gain who fail to respond to other obesity interventions. "We believe this
effective novel obesity treatment, which is easily implemented in a
clinical
setting, could have important implications for women with Syndrome W, and
quite possibly for other subpopulations of obese nondiabetic Americans
with
progressive weight gain and documented hyperinsulinemia," they conclude.



http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=R
Retrieve&db=PubMed&dopt=Abstract&list_uids=1463332 1

It's pretty nasty stuff, producing extremely unpleasant digestive problems
in some people and a potentially fatal condition, lactic acidosis, in
others.

Nasty is correct! I tried EVERYTHING, eating it with food, before food, after
food, even on an empty stomach (not recommended) and it made me feel queasy,
runny and TIRED. I could barely function on that stuff. Sleeping 20 hours a day
would have been easy if my work/family had allowed it. After about 6 weeks I
had to toss it. If I keep my carbs at 20-30 grams per day, there's no need for
it anyway. And I feel better than ever!


LCing since 12/01/03-
Me- 265/240/140
& hubby- 310/271/180

Agreed. Metformin is not without its risks. But it may be an extemely
effective drug for insulin insensitivity. In some animal experiments,
it appears to increase maximum life-span. It also displays some
metabolic effect that may inhibit and prevent cancer.



"Jenny" wrote in message ...
Roger,

Of course, what the article fails to report is that a "carbohydrate modified
diet" _without_ metformin will also produce long term weight loss for middle
aged ladies too. g

Metformin should only be considered after you've stalled for a long time
while eating a controlled calorie, low carb diet., or when a low carb diet
is not controlling diabetic blood sugar, or if you have have been diagnosed
with PCOS.

It's pretty nasty stuff, producing extremely unpleasant digestive problems
in some people and a potentially fatal condition, lactic acidosis, in
others.

I tried it after my 3 year stall only to find that it caused two disturbing
side effects. One, which is rare, is that it caused me to have intense
reactive low blood sugar attacks which made me faint and dizzy (my blood
sugar dropped into the low 60s after every meal after a few months on it.)
The other was that it gave me wierd cramps in my upper left chest that felt
like I was having a heart attack. The endocrinologist told me that was a
"known effect."


-- Jenny

Susan wrote:








Pretty rare effects, from all I've read about it from many who are IR and
who've taken it long term. IME, it made me extraordinarily fatigued, as does
any drug that alters the way my liver works.

Metformin has been around for many years, has a very good safety profile, is a
highly potent antioxidant and a safe bet for those whose weight may be high
enough to predispose to CVD and/or diabetes.

Susan

Metformin used as an antioxidant? What about a diabetic on low carbs? Wouldn't
that lower the BG too much if used as an antioxidant? Just wondering.

Myway

"Susan " wrote ...

Pretty rare effects, from all I've read about it from many who are IR and
who've taken it long term. IME, it made me extraordinarily fatigued, as
does
any drug that alters the way my liver works.

I'm just suffering the effects of moving up to a full dosage over the last
few days ... I'm interested in your comments about the liver - should I be
asking the doc to give me liver function tests from time to time, or is it
not that sort of liver effect?


cheers
Rachel
(New Zealand)

Rachel,

Lactic acidosis causes muscle pain and muscle weakness along with the usual
gastrointestinal symptoms. . If you google "lactic acidosis" on the Google
Groups Search you'll find quite a few people posting about their experiences
with it.

If you've had any blood tested recently, your doctor might have included a
liver enzyme test. It might be worth asking him. It's not an expensive test
and it does give you a baseline against which to check for any changes.
Since most of us only get one liver, and don't last very long when it is
broken, it's worth doing.

Is the metformin helping with weight loss? When it works, it seems to work
extremely well for people. I hope you are one of them!

-- Jenny - Low Carbing for 4 years. At goal for weight. Type II diabetes,
hba1c 5.2.
Cut the carbs to respond to my email address!

Low carb facts and figures, my weight-loss photos, tips, recipes and more at
http://www.geocities.com/jenny_the_bean/

Looking for help controlling your blood sugar?
Visit http://www.alt-support-diabetes.org/...0Diagnosed.htm



"Supergoof" wrote in message
...
"Susan " wrote ...

Pretty rare effects, from all I've read about it from many who are IR
and
who've taken it long term. IME, it made me extraordinarily fatigued, as
does
any drug that alters the way my liver works.

I'm just suffering the effects of moving up to a full dosage over the last
few days ... I'm interested in your comments about the liver - should I be
asking the doc to give me liver function tests from time to time, or is it
not that sort of liver effect?


cheers
Rachel
(New Zealand)

"Jenny" wrote ...

Lactic acidosis causes muscle pain and muscle weakness along with the
usual
gastrointestinal symptoms. . If you google "lactic acidosis" on the Google
Groups Search you'll find quite a few people posting about their
experiences
with it.

Thanks Jenny. My GP went through the lactic acidosis risks and stuff like
don't take metformin if you have been vomiting or have severe diarrhoea
(something I find deeply ironic since the stuff gives you just that!). That
was a few years ago, pre-LC and didn't make any different to my weight (I
think my max dose was 1500mg/day at the time). It was prescribed by an
endocrinologist again recently (2000mg/day), but she never went into any of
the risks (I'm very distrustful of any medical professional who can be a
spokesperson for a group called "FOE - Fight the Obesity Epidemic" anyway -
annoying skinny person who runs 3 times a day or something excessive like
that).

I was told I had a fatty liver before starting LC, but after 6 months on LC
the last test was normal (had a slightly abnormal liver test about 6 years
back when I was on roaccutane too, so I'm thinking it's been like that for
years prior to starting low carb, which is another plus for the diet!). So I
guess I sort of have a baseline to work from. The endocrinologist has given
me a form to have blood tests a week or so before my follow-up appointment
in 3 months, and "liver tests" is among them, which is good to know.

Since most of us only get one liver, and don't last very long when it is
broken, it's worth doing.

Don't I know it - my dad died of liver cancer 4 years ago next month. (


Is the metformin helping with weight loss? When it works, it seems to
work
extremely well for people. I hope you are one of them!

Fingers crossed - it's probably too early to tell at the moment. I haven't
been taking it regularly - just got up to the full dosage and then went
off-plan (and off the metformin) when I went away to a friend's wedding, and
stayed off both for the following week as I had some minor surgery ... then
of course went back to one tablet twice a day, but had trouble remembering
the evening dose - this went on for a couple of weeks then I took 10 days
off again around Christmas ... so I'm back on everything with a vengeance
this week, so fingers crossed it will help, as I have been LC for about 18
months now but wasn't losing anything - not even during induction. Lost the
4kgs I'd gained when I started taking Avandia when we knocked off the cream
cheese desserts and started walking, but the walking's fallen by the wayside
with all the other disruptions of the past couple of months. (I tried
avandia hoping it would have the beneficial effects of metformin without the
risks or side-effects, but all it did was make me gain weight!) Interesting
losing those 4kgs made one of my spare tyres change a little - not sure if
it's smaller or just lower - either way it was a positive change - of course
have regained 2kgs with all my misbehaving over the last month, but that is
the last cheat for quite some time, I would hope.

cheers
Rachel
(New Zealand)

"Susan " wrote ...
Rachel wrote ...

I'm just suffering the effects of moving up to a full dosage over the
last
few days ... I'm interested in your comments about the liver - should I
be
asking the doc to give me liver function tests from time to time, or is
it
not that sort of liver effect?

Many folks report short term fatigue on it. If you're taking it, odds are
your
routine lab work includes liver enzymes/routine chemistry.

If you get severe fatigue, headachey and body aches, I'd ask the doc about
it
right away.

heh none of the above more than usual for me, at any rate.

)

Rachel
(New Zealand)

Rachel,

Metformin is the only medication that has been proven to reverse fatty
liver, so it shouldn't worsen that problem even if you had it. But it is
good that your doctor is keeping an eye on the tests.

So sorry to hear about your dad's sad death. Someone who had once been very
important to me died of liver cancer this past year, too.

As far as Avandia goes, the endocrinologist I consulted told me it packs
weight on most people, mostly on the arms and legs. I read up about it and
it seems that the way it works is to make it easier for insulin to push
glucose into the muscle tissues, which would make weight gain easier.

Here's hoping that low carbing and the metformin together work for you this
time!


-- Jenny - Low Carbing for 4 years. At goal for weight. Type 2 diabetes,
hba1c 5.2.
Cut the carbs to respond to my email address!

Low carb facts and figures, my weight-loss photos, tips, recipes and more at
http://www.geocities.com/jenny_the_bean/

Looking for help controlling your blood sugar?
Visit http://www.alt-support-diabetes.org/...0Diagnosed.htm



"Supergoof" wrote in message
news:1073264060.112528@muldoon...
"Jenny" wrote ...

Lactic acidosis causes muscle pain and muscle weakness along with the
usual
gastrointestinal symptoms. . If you google "lactic acidosis" on the
Google
Groups Search you'll find quite a few people posting about their
experiences
with it.

Thanks Jenny. My GP went through the lactic acidosis risks and stuff like
don't take metformin if you have been vomiting or have severe diarrhoea
(something I find deeply ironic since the stuff gives you just that!).
That
was a few years ago, pre-LC and didn't make any different to my weight (I
think my max dose was 1500mg/day at the time). It was prescribed by an
endocrinologist again recently (2000mg/day), but she never went into any
of
the risks (I'm very distrustful of any medical professional who can be a
spokesperson for a group called "FOE - Fight the Obesity Epidemic"
anyway -
annoying skinny person who runs 3 times a day or something excessive like
that).

I was told I had a fatty liver before starting LC, but after 6 months on
LC
the last test was normal (had a slightly abnormal liver test about 6 years
back when I was on roaccutane too, so I'm thinking it's been like that for
years prior to starting low carb, which is another plus for the diet!). So
I
guess I sort of have a baseline to work from. The endocrinologist has
given
me a form to have blood tests a week or so before my follow-up appointment
in 3 months, and "liver tests" is among them, which is good to know.

Since most of us only get one liver, and don't last very long when it is
broken, it's worth doing.

Don't I know it - my dad died of liver cancer 4 years ago next month. (


Is the metformin helping with weight loss? When it works, it seems to
work
extremely well for people. I hope you are one of them!

Fingers crossed - it's probably too early to tell at the moment. I haven't
been taking it regularly - just got up to the full dosage and then went
off-plan (and off the metformin) when I went away to a friend's wedding,
and
stayed off both for the following week as I had some minor surgery ...
then
of course went back to one tablet twice a day, but had trouble remembering
the evening dose - this went on for a couple of weeks then I took 10 days
off again around Christmas ... so I'm back on everything with a vengeance
this week, so fingers crossed it will help, as I have been LC for about 18
months now but wasn't losing anything - not even during induction. Lost
the
4kgs I'd gained when I started taking Avandia when we knocked off the
cream
cheese desserts and started walking, but the walking's fallen by the
wayside
with all the other disruptions of the past couple of months. (I tried
avandia hoping it would have the beneficial effects of metformin without
the
risks or side-effects, but all it did was make me gain weight!)
Interesting
losing those 4kgs made one of my spare tyres change a little - not sure if
it's smaller or just lower - either way it was a positive change - of
course
have regained 2kgs with all my misbehaving over the last month, but that
is
the last cheat for quite some time, I would hope.

cheers
Rachel
(New Zealand)