Although the Glaser Pediatric Research Network Obesity Study Group1 appropriately calls for more research on the long-term use of metformin, we are concerned that the door continues to be open for the off-label prescribing of metformin, with potential harms outweighing any demonstrated long-term benefit in the treatment of adolescent obesity. In their study, the authors reported that at the end of 48 weeks, the adjusted body mass index (BMI) mean was increased by 0.2 in the control group and decreased by 0.9 in the metformin extended release (XR) group, and the difference in favor of metformin persisted for 12 to 24 weeks after treatment cessation. Our analysis of the primary end point at 48 rather than 24 weeks after treatment cessation indicates a greater benefit for the lifestyle intervention compared with metformin treatment. As shown in Table 2, after 48 weeks of treatment cessation, the adjusted BMI mean was decreased by 0.8 in the control group and increased by 0.6 in the metformin XR group (P = .02). The differences from baseline was −0.7 and −0.3, respectively.
Sukkari SR, Sasich LD, Humaidan AS, Burikan O. Analysis of Metformin Treatment for Adolescent Obesity at 48 Rather Than 24 Weeks After Treatment Cessation. Arch Pediatr Adolesc Med. 2010;164(7):678-679. doi:10.1001/archpediatrics.2010.110