The effect of comprehensive lifestyle intervention or metformin on obesity in young women.
OBJECTIVE
Young women are at high risk of weight gain but few weight management interventions have been investigated in this group. This study aimed to determine the effect of metformin on body weight, body composition, metabolic risk factors and reproductive hormone levels in overweight or obese young women compared to placebo and comprehensive lifestyle intervention.


RESULTS
203 overweight or obese young women (BMI 33.2+/-0.3 kg/m², age 28+/-0.3 years) were randomised to 1500 mg/day metformin (M) plus general lifestyle advice, placebo (P) plus general lifestyle advice or comprehensive lifestyle intervention including structured diet, exercise and behavioural therapy (L) for 12-weeks. At 12-weeks, linear mixed models found that L group had greater weight loss (-4.2+/-0.4 kg) compared to M (-1.0+/-0.4 kg) and P groups (-0.2+/-0.3 kg) (P < 0.0001). Weight loss between M and P groups were not significantly different. Attrition rate was 48% for L, 34% for M and 29% for P (P = 0.08). Intention-to-treat analysis showed that 10% (8/79) of the subjects in P group had gained weight (>3%), compared to 3% (2/65) from M group and none (0/59) from L group (P < 0.001). The L group had the greatest decrease in waist circumference (-5.2+/-0.7 cm) and fat mass (-5.4+/-0.7 kg) compared to the other groups (P < 0.05). No significant time-by-group effects were seen in plasma lipids, SHBG, testosterone, blood pressure, serum folate, serum ferritin and serum vitamin B12.


CONCLUSIONS
Lifestyle intervention was more effective in reducing body weight and improving body composition compared to metformin among healthy overweight or obese young women.
Lim
S S
SS
Discipline of Physiology, School of Molecular and Biomedical Science, Adelaide University, SA 5000, Australia. siew.seen.lim@gmail.com
Norman
R J
RJ
Clifton
P M
PM
Noakes
M
M
D000293:Adolescent; D000328:Adult; D001521:Behavior Therapy; D001823:Body Composition / Q000187:drug effects; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects; D004311:Double-Blind Method; D015444:Exercise; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D057194:Intention to Treat Analysis; D008019:Life Style; D008687:Metformin / Q000627:therapeutic use*; D009765:Obesity / Q000178:diet therapy / Q000188:drug therapy* / Q000628:therapy*; D050177:Overweight / Q000178:diet therapy / Q000188:drug therapy / Q000628:therapy; D010349:Patient Compliance; D010352:Patient Dropouts; D055105:Waist Circumference / Q000187:drug effects; D055815:Young Adult
D007004:Hypoglycemic Agents; D008687:Metformin