Metformin showed a modest BMI advantage in youth taking antipsychotics
Adding metformin to lifestyle guidance favored the BMI outcome, while gastrointestinal side effects were more common.
Based on the published abstract. The full paper may contain additional methods, results and limitations.
The 30-second takeaway
In youth taking antipsychotics who had bipolar spectrum disorders and overweight or obesity, adding metformin to lifestyle guidance produced a modest advantage in the BMI outcome. The reported effect was smaller at the later assessment. Gastrointestinal side effects were more common, so the result involves a tolerability tradeoff.
The trial was unblinded, and some follow-up data were missing. This abstract-based account cannot provide an absolute weight difference in kilograms.
What researchers found
Standardized between-group effect on BMI Z-score change
Metformin plus LIFE versus LIFE alone at 6 months; p<0·0001.
Standardized between-group effect on BMI Z-score change
Metformin plus LIFE versus LIFE alone at 24 months; p=0·047.
Understanding the effect sizes
BMI Z-score adjusts BMI for age and sex. The reported 0·26 and 0·11 are standardized between-group effects favoring metformin, rather than direct changes of those amounts in BMI Z-score units or percentages of body weight lost.
Safety findings
The groups did not differ significantly on the reported suicide-related measure during treatment. A nonsignificant result does not establish equal safety, and the abstract separately reports more gastrointestinal adverse events with metformin.
The original publication
Metformin for overweight and obese children and adolescents with bipolar spectrum and related mood disorders treated with second-generation antipsychotics: a randomised, pragmatic trial.
DelBello MP, Welge JA, Klein CC et al.
Lancet Psychiatry · 2025
- PubMed ID
- 41233082
- Record checked
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