Metformin for Obesity in Children and Adolescents: A Systematic Review

Min Hae Park, MSC; Sanjay Kinra, MD, PHD; Kirsten J. Ward, PHD; Billy White, MBBS; Russell M. Viner, MBBS, PHD


Diabetes Care. 2009;32(9):1743-1745. 

In This Article

Abstract and Introduction


Objective—To summarize the efficacy of metformin in reducing BMI and cardiometabolic risk in obese children and adolescents without diabetes.
Research design and methods—We performed a systematic review and meta-analysis of randomized controlled trials (RCTs). Double-blind RCTs of ≥6 months duration in obese subjects age ≤19 years without diabetes were included. Our primary outcomes of interest include changes in BMI and measures of insulin sensitivity.
Results—Five trials met inclusion criteria (n = 320 individuals). Compared with placebo, metformin reduced BMI by 1.42 kg/m2 (95% CI 0.83–2.02) and homeostasis model assessment insulin of resistance (HOMA-IR) score by 2.01 (95% CI 0.75–3.26).
Conclusions—Metformin appears to be moderately efficacious in reducing BMI and insulin resistance in hyperinsulinemic obese children and adolescents in the short term. Larger, longer-term studies in different populations are needed to establish its role in the treatment of overweight children.


Metformin has been shown to reduce weight gain, hyperinsulinemia, and hyperglycemia in adults with type 2 diabetes[1,2] and to reduce progression from impaired glucose tolerance to diabetes in those without diabetes.[3] These benefits have led to an increase in the use of metformin in obese children with hyperinsulinemia. However, obesity is not a licensed indication for metformin in the U.K. or the U.S., and its use has proceeded faster than the evidence of its benefits. We undertook a systematic review of randomized controlled trials (RCTs) investigating the efficacy of metformin for reducing BMI and cardiometabolic risk in obese children without diabetes.


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