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Metformin for obesity in children and adolescents: a systematic review

Min Hae Park1, Sanjay Kinra, Kirsten J Ward

  • 1Non-Communicable Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, London, UK.

Diabetes Care
|June 9, 2009
PubMed

Insights

Metformin moderately reduces BMI and improves insulin sensitivity in obese children and adolescents without diabetes. Further research is needed to confirm its long-term effectiveness and role in managing pediatric obesity.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Syndrome Research
  • Pharmacological Interventions in Obesity

Background:

  • Childhood obesity is a growing global health concern.
  • Obesity in youth is linked to increased cardiometabolic risk and insulin resistance.
  • Effective pharmacological interventions are needed for pediatric obesity management.

Purpose of the Study:

  • To systematically review and meta-analyze the efficacy of metformin in reducing Body Mass Index (BMI) and cardiometabolic risk.
  • To assess metformin's impact on insulin sensitivity in obese children and adolescents without diabetes.

Main Methods:

  • Systematic review and meta-analysis of double-blind randomized controlled trials (RCTs).
  • Included RCTs were of at least 6 months duration in obese subjects aged 19 years or younger without diabetes.
  • Primary outcomes assessed were changes in BMI and insulin sensitivity measures.

Main Results:

  • Five trials involving 320 individuals met the inclusion criteria.
  • Metformin significantly reduced BMI by 1.42 kg/m² compared to placebo.
  • Metformin also decreased the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) score by 2.01.

Conclusions:

  • Metformin demonstrates moderate short-term efficacy in reducing BMI and insulin resistance in hyperinsulinemic, obese pediatric populations.
  • Larger, longer-term studies are required to fully establish metformin's role in treating overweight children.
  • Further research should explore metformin's utility across diverse pediatric populations with obesity.
Abstract

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