Metformin for Obesity in Children and Adolescents: A Systematic Review

  1. Min Hae Park, MSC1,
  2. Sanjay Kinra, MD, PHD1,
  3. Kirsten J. Ward, PHD2,
  4. Billy White, MBBS3 and
  5. Russell M. Viner, MBBS, PHD3
  1. 1Non-Communicable Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, London, U.K.;
  2. 2Cochrane Heart Group, Non-Communicable Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, London, U.K.;
  3. 3UCL Institute of Child Health, University College London, London, U.K.
  1. Corresponding author: Russell M. Viner, r.viner{at}


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.


  • The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Received February 16, 2009.
    • Accepted May 29, 2009.
| Table of Contents

This Article

  1. Diabetes Care vol. 32 no. 9 1743-1745
  1. Online-Only Appendix
  2. All Versions of this Article:
    1. dc09-0258v1
    2. 32/9/1743 most recent