Metformin induces significant reduction of body weight, total cholesterol and LDL levels in the elderly - A meta-analysis

PLoS One. 2018 Nov 26;13(11):e0207947. doi: 10.1371/journal.pone.0207947. eCollection 2018.


Background: Metformin is the first-choice drug for patients with Type 2 diabetes, and this therapy is characterized by being weight neutral. However, in the elderly an additional unintentional weight loss could be considered as an adverse effect of the treatment.

Objectives: We aimed to perform a meta-analysis of placebo-controlled studies investigating the body weight changes upon metformin treatment in participants older than 60 years.

Materials and methods: PubMed, EMBASE and the Cochrane Library were searched. We included at least 12 week-long studies with placebo control where the mean age of the metformin-treated patients was 60 years or older and the body weight changes of the patients were reported. We registered our protocol on PROSPERO (CRD42017055287).

Results: From the 971 articles identified by the search, 6 randomized placebo-controlled studies (RCTs) were included in the meta-analysis (n = 1541 participants). A raw difference of -2.23 kg (95% CI: -2.84 --1.62 kg) body weight change was detected in the metformin-treated groups as compared with that of the placebo groups (p<0.001). Both total cholesterol (-0.184 mmol/L, p<0.001) and LDL cholesterol levels (-0.182 mmol/L, p<0.001) decreased upon metformin-treatment.

Conclusions: Our meta-analysis of RCTs showed a small reduction of body weight together with slight improvement of the blood lipid profile in patients over 60 years. With regard to the risk of unintentional weight loss, metformin seems to be a safe agent in the population of over 60 years. Our results also suggest that metformin treatment may reduce the risk of major coronary events (-4-5%) and all-cause mortality (-2%) in elderly diabetic populations.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Obesity Agents / therapeutic use*
  • Anticholesteremic Agents / therapeutic use*
  • Body Weight / drug effects*
  • Cholesterol / blood*
  • Humans
  • Hypoglycemic Agents
  • Metformin / therapeutic use*
  • Middle Aged
  • Randomized Controlled Trials as Topic


  • Anti-Obesity Agents
  • Anticholesteremic Agents
  • Hypoglycemic Agents
  • Metformin
  • Cholesterol

Grant support

This study was supported by an Economic Development and Innovation Operative Programme Grant (GINOP 2.3.2-15-2016-00048) and an Institutional Developments for Enhancing Intelligent Specialization Grant (EFOP-3.6.3-VEKOP-16-2017-00009 and EFOP-3.6.2-16-2017-0006) of the National Research, Development and Innovation Office.