Metformin (Glucophage) is approved for use in patients with diabetes but it is not a weight loss medication. In comparison with some other traditional diabetes therapies, which might result in weight gain, Metformin has been shown to be associated with a small amount of weight loss. The indication for prescribing Metformin is to treat the insulin resistance associated with Type 2 diabetes and not for weight control in healthy overweight people.

Much more dramatic is the weight loss achieved in people with Type 2 diabetes prescribed the medication based on incretin hormones. The subcutaneously injected GLP-1 hormone analogues, Byetta or Victoza are currently available for treatment of Type 2 diabetes. With continuous usage for diabetes control there can be an associated weight loss of approximately 10% of body weight over one year. These treatments, based on the hormone interactions within the gastrointestinal tract, appear to achieve this remarkable result through a variety of mechanisms involving regulation of gastric emptying, insulin release and action and on the brain mechanisms controlling appetite and satiety.

Pramlintide (Symlin) is a synthetic analogue of the hormone Amylin which is normally secreted by the pancreas in response to eating. Amylin controls weight by delaying gastric emptying and by promoting a feeling of satiety. Research has shown that many patients with diabetes are deficient in Amylin and Symlin is now approved in the United States for use in people with both Type 1 and Type 2 diabetes. Being a protein-based hormone, the drug would be destroyed by the gastric juices. It is therefore, like Byetta and Victoza, only available as a subcutaneous injection.

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