title: Effects of metformin on energy intake and satiety in obese children.
abstract: OBJECTIVE
  To investigate the effects of metformin on appetite and energy intake in obese children with hyperinsulinaemia.
  
  
  METHODS
  We conducted a 6-month randomized, double-blind, placebo-controlled trial to evaluate the effects of metformin 1000 mg twice daily on body weight and energy balance in 100 obese children with hyperinsulinaemia aged 6-12 years. The children ate ad libitum from standardized food arrays on two separate occasions before and after 6 months of study medication. The first test meal was consumed after an overnight fast. The second was preceded by a pre-meal load. For each test meal, energy intake was recorded, and the children completed scales of hunger, fullness and desire to eat.
  
  
  RESULTS
  Data from the meal studies at baseline and after treatment with study medication were available for 84 children (metformin-treated, n = 45; placebo-treated, n = 39). Compared with placebo, metformin treatment elicited significant reductions from baseline in adjusted mean ± standard error of the mean energy intake after the pre-meal load (metformin: -104.7 ± 83.8 kcal vs. placebo: +144.2 ± 96.9 kcal; p = 0.034) independently of changes in body composition. Metformin also significantly decreased ratings of hunger (-1.5 ± 5.6 vs. +18.6 ± 6.3; p = 0.013) and increased ratings of fullness (+10.1 ± 6.2 vs. -12.8 ± 7.0; p = 0.01) after the pre-meal load.
  
  
  CONCLUSIONS
  These data suggest that decreased perceived hunger resulting in diminished food intake are among the mechanisms by which metformin treatment reduces body weight in overweight children with hyperinsulinaemia.
authors.affiliation: Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Adeyemo
authors.forename: J R
authors.initials: JR
authors.lastname: McDuffie
authors.forename: M
authors.initials: M
authors.lastname: Kozlosky
authors.forename: J
authors.initials: J
authors.lastname: Krakoff
authors.forename: K A
authors.initials: KA
authors.lastname: Calis
authors.forename: S M
authors.initials: SM
authors.lastname: Brady
authors.forename: J A
authors.initials: JA
authors.lastname: Yanovski
mesh_terms: D001067:Appetite Depressants / Q000009:adverse effects / Q000627:therapeutic use*; D015992:Body Mass Index; D002648:Child; D002652:Child Behavior / Q000187:drug effects; D002664:Child Nutritional Physiological Phenomena / Q000187:drug effects*; D003131:Combined Modality Therapy / Q000009:adverse effects; D004038:Diet, Reducing; D004311:Double-Blind Method; D002149:Energy Intake / Q000187:drug effects*; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000209:etiology / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008019:Life Style; D008297:Male; D008687:Metformin / Q000009:adverse effects / Q000627:therapeutic use*; D009043:Motor Activity; D009316:National Institutes of Health (U.S.); D056687:Off-Label Use; D010290:Parents / Q000193:education; D010353:Patient Education as Topic; D063766:Pediatric Obesity / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy; D012528:Satiety Response / Q000187:drug effects*; D014481:United States; D015431:Weight Loss / Q000187:drug effects
chemical_list: D001067:Appetite Depressants; D007004:Hypoglycemic Agents; D008687:Metformin
keywords: child; energy intake; insulin resistance; metformin; obesity