Study Suggests Metformin Could Help Recovery From Food Insecurity, Anorexia

New research suggests that the widely used diabetes drug metformin could help patients recovering from short periods of severe food insecurity or anorexia, according to findings presented at the American Physiology Summit.¹

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Unlike modest food restriction, which can benefit overall metabolic health, even short periods of severe food restriction can have long-lasting health effects. Experts estimate that between 1% and 4% of women will experience severe food intake reduction from anorexia nervosa during their lifetime, and just under 4% of households in the United States are estimated to experience periods of severe food restriction due to food insecurity each year.¹

Refeeding syndrome can be a life-threatening complication of reintroducing calories after severe food reduction, most often occurring in patients with severe anorexia nervosa who are severely malnourished and are receiving a diet of increasing calories either orally, intravenously, or via nasogastric tube. In patients experiencing refeeding syndrome, a dangerous shift in fluids and electrolytes occurs in the body, resulting in compromised cardiovascular status, respiratory failure, seizures, and even death.²

“Although it is well known that starvation or severely reduced diets can damage organs such as the heart and kidney, scientists don’t understand the underlying molecular causes for the damage, whether it persists and whether it can be reversed,” said research team leader Carolyn Ecelbarger, PhD, an associate professor of medicine from Georgetown University, in a press release. “The hope is that we may be able to intervene, potentially even in a later time frame, and short-circuit the development of chronic disease and organ injury.”¹

Using a rat model to examine the health effects of short periods of severe caloric restriction, the investigators found that a severe reduction in food intake lasting just 2 weeks caused damage to the heart and kidneys that appeared to be irreversible, even after the body weight was restored. During a 2-month refeeding period during which rats could eat as much as they wanted, some rats also developed signs of prediabetes, such as increased abdominal obesity.¹

To test whether any of the negative effects from reduced food consumption could be reversed, some rats received metformin for 5 weeks during a refeeding period. These rats showed reduced abdominal obesity and improvements in some measures of heart health, including cardiac output, which indicates how much blood is pumped out of the heart with each beat.¹

“This strategy could have the potential to positively affect enormous numbers of individuals,” Ecelbarger said in the press release. “However, more work is needed to find the best timing and most effective doses for treatment. We are also exploring other drugs, such as FDA-approved blood pressure medications.”¹

REFERENCES

1. Diabetes Drug Could Aid Recovery from Bouts of Food Insecurity or Anorexia. News release. American Physiological Society. April 21, 2023. Accessed April 17, 2023.
2. Refeeding Syndrome Symptoms and Warning Signs. Acute Center for Eating Disorders & Severe Malnutrition. February 25, 2021. Accessed April 17, 2023. https://www.acute.org/resource/refeeding-syndrome-signs-symptoms#:~:text=In%20patients%20experiencing%20refeeding%20syndrome,failure%2C%20seizures%20and%20even%20death