Metformin for weight loss

To get a prescription for metformin with or without diabetes, you need to see a licensed provider. If they think you’ll benefit from metformin without a diabetes diagnosis, they can prescribe it for you. Common off-label uses of metformin that aren’t FDA-approved include obesity, weight gain from taking an antipsychotic medication, preventing type 2 diabetes, gestational diabetes, and polycystic ovary syndrome.

If you do get a prescription, your insurance company may want prior authorization, which they may deny if they don’t think your taking it is medically necessary. If they deny your authorization, you may have to pay full price for metformin.

Metformin is a prescription medication. Be wary of any store — online or brick and mortar — that offers metformin without a prescription. Use a licensed, certified pharmacy that requires a prescription for your healthcare provider instead.

Some people will notice that they’re less hungry in as little as a week. In clinical trials, people taking metformin typically started seeing weight loss in 4 weeks. Most weight loss happens in the first 6 to 12 months.

If you and your provider agree that getting compounded metformin is right for you and you use a licensed, reputable compounding pharmacy, choosing a compounding pharmacy is a safe option. Note though that compounded medications aren’t the same as FDA-approved medications and may contain different ingredients. Always talk to your provider about choosing a compounded medication.

Feeling less hungry, less thirsty, and urinating less are signs that metformin is working for you. After about 4 weeks, having lost a small amount of weight or having not gained weight is a  good sign it’s working.

If you’re using it for type 2 diabetes, it will also help lower your blood sugar levels, which you’ll see when you test your blood glucose.

Many insurance plans cover metformin. The best way to find out if your plan does is to call its customer service department and ask. Some insurance companies will ask for a prior authorization (PA) to prove metformin is medically necessary for you. That’s essentially a process where your provider submits paperwork and your insurance company or a third-party reviewer decides whether you need it based on your provider’s submission. If your insurance company doesn’t approve your PA, they won’t cover it for you. You can appeal a prior authorization denial

No. In clinical trials, people taking Mounjaro (tirzepatide) have lost more weight than in trials for metformin. On Mounjaro, trial participants generally lose up to 13.9% body weight in 104 weeks compared to 5% on metformin after a year. 

Semaglutide in Ozempic helps people lose more than metformin. Ozempic was so successful at helping people lose weight that Novo Nordisk, who makes Ozempic, got a stronger version of it, called Wegovy, FDA-approved specifically for weight loss.

In clinical trials, people taking 2 milligrams of Ozempic per week for type 2 diabetes lost at least 5% and sometimes more than 10% of their body weight in 40 weeks. That’s potentially twice as much, and faster, compared to people who lost 5% on metformin after a year. 

Learn more about Metformin vs Ozempic for weight loss and which is better.