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Metformin is a medication prescribed to treat type 2 diabetes by managing blood sugar levels.1 However, many people misuse metformin to lose weight, though it’s not approved for stand-alone weight loss treatment. Taking metformin as a diet pill or miracle weight loss drug can be harmful to your health, increase your risk of disordered eating, or indicate the presence of an active eating disorder.
Metformin, which is sold under the brand names Fortamet, Glumetza, Glucophage, and Riomet, is a prescription medication approved by the Food and Drug Administration (FDA) to treat type 2 diabetes, although it has many off-label uses, including:3
Although metformin is a prescription medication for type 2 diabetes, people without this condition have begun taking it to lose weight. Misusing metformin for weight loss can be risky and cause dangerous consequences, especially since it isn’t approved for this purpose.6
Taking metformin can cause various side effects, including:1
Serious metformin risks may include chest pain or a rash, which could indicate an allergic reaction.1 If you experience a dangerous adverse effect, call 911 or your doctor immediately.
It is possible to overdose on metformin, although metformin overdoses tend to be relatively rare. That said, they can cause devastating consequences, including death.2
Metformin overdose symptoms may resemble hypoglycemia symptoms, such as:1
Severe metformin intoxication or an overdose can also cause severe lactic acidosis (or severe metabolic acidosis), which can cause a host of symptoms, such as:4
Furthermore, overdosing on metformin can also impair kidney function due to poor blood flow.2
If you suspect someone has overdosed on metformin or has metformin poisoning, call 911 immediately. Stay on the line and answer all the operator’s questions to the best of your ability. Once they hang up, remain with the person until first responders arrive.
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Taking metformin for weight loss could be a sign of disordered eating or even a clinical eating disorder, such as anorexia, bulimia, or binge eating disorder, especially if you experience other eating disorder symptoms. Depending on the condition, these symptoms may include:5
In one case study, a woman with anorexia-binge purge type misused metformin, which she’d bought on the black market online. She used metformin as a form of purging behavior, which has rarely been reported but is extremely life-threatening.6
Another case study revealed that a woman with body dysmorphic disorder had been misusing high doses of metformin for three years, which led to a myriad of overdose symptoms and toxicity episodes, including kidney damage, heart issues, dangerously low sodium levels, low blood cell count, and more.7
Misusing medications like metformin is popular because of the massive influence diet culture, healthism, and weight stigma have over our society.6 Diet culture, which is present virtually everywhere, has convinced us that there is an “ideal” body type we must achieve—and people often seek quick fixes or miracle weight loss drugs to help.
Weight stigma and fatphobia are even present in healthcare, including diagnostic and treatment settings. Doctors may prescribe metformin for “pre-diabetes,” meaning someone is at risk for developing type 2 diabetes, based on their weight or BMI (which is outdated, an inaccurate predictor of health, and actively harmful). However, it may not be safe or beneficial to take this prescription medication when you aren’t actually at risk for type 2 diabetes. Understanding weight bias and the principles of Health at Every Size (HAES) can help prepare you for discriminatory physicians and potential metformin risks.
If you are taking medication like metformin or are engaging in disordered eating behaviors, professional treatment can help, especially from a treatment program that is inclusive and follows the HAES approach. Although in-person care in an inpatient or outpatient treatment setting can be helpful for many, more and more people are considering virtual care, given its flexibility and accessibility.
Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.
Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.
Metformin is not typically prescribed for stand-alone weight loss, and if it is, it’s an off-label use, meaning metformin isn’t FDA-approved as a weight loss medication. However, it can be used to help people with type 2 diabetes lose weight.1
If you have type 2 diabetes and are prescribed metformin, it is generally considered safe to take.1 However, if you misuse metformin as a diet pill or weight-loss drug, it can cause dangerous side effects and consequences.
Metformin affects everyone differently, but common side effects may include headache, flushing of the skin, muscle pain, heartburn, diarrhea, bloating, stomach pain, gas, and constipation.1 In some cases, metformin-associated lactic acidosis may also occur.9
Metformin is not FDA-approved to treat binge eating disorder nor is it commonly prescribed off-label. The only FDA-approved medication for binge eating disorder is Vyvanse.8
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