Normoglycemic, hyperinsulinemic women with midlife weight gain showed improved 12-month weight loss with metformin combined with a novel carbohydrate-modified diet, according to results from the EMPOWIR trial.
Harriette Mogul, MD, MPH, of the division of endocrinology and metabolism in the department of medicine at Taylor Care Center in Valhalla, New York, and colleagues evaluated 39 women (mean age, 46.7 years; mean BMI, 30.8 kg/m2) with more than 20 lb weight gain, normal glucose tolerance test and increased area under the curve (AUC) insulin.
All participants attended four nutrition workshops to introduce a carbohydrate-modified diet and were then randomly assigned to the diet alone, the diet plus metformin or metformin plus rosiglitazone for 6 months. From months 7 to 12, participants assigned to the diet alone were reassigned to one of the treatment arms. Thirty-two participants returned for the 12-month visit.
At 12 months, the metformin group demonstrated significant progressive mean weight loss from baseline (85.1 kg) to 6 months (80.5 kg) and 12 months (79.8 kg; P = .0003). From baseline to 6 months, mean body weight decreased in the metformin plus rosiglitazone group (81.6 kg to 76.8 kg) but increased from 7 to 12 months (78.3 kg). Over time, mean body weight decreased among all participants: at baseline, 84 kg; at 6 months, 79.2 kg; and at 12 months, 78.6 kg (P = .001). Percent change in fasting insulin was linked to percent change in body weight (P = .002).
Fifty percent of participants who returned for the 12-month visit lost 5% or more of their body weight.
“The EMPOWIR diet in combination with metformin sustained and enhanced 12-month body weight reduction and reduced android fat in diverse overweight and obese normoglycemic women with midlife weight gain and documented hyperinsulinemia,” the researchers wrote. “Notably, reported body weight and body composition changes were achieved with minimal formal behavioral, nutritional counseling — four workshops conducted prior to randomization, a minimum of 12 months earlier. These findings suggest that specific interventions targeting the metabolic profile of overweight and obese individuals may represent an alternative approach to more conventional weight reduction strategies based exclusively on caloric restriction.” – by Amber Cox
The researchers report no relevant financial disclosures.