Injection
Tirzepatide + B12
A weekly dual-action GLP-1/GIP injection for meaningful weight loss and appetite control, paired with vitamin B12 for energy.
Starting at $198/mo
Weight lossOral medicationMetabolic
Metformin
RxPrescription onlyTaken by mouth · Once a day · 1–500 mg · Weight loss · Oral medication · Metabolic
Starting at $79/mo
Oral metformin, used off-label for weight loss and metabolic health. Metformin improves insulin sensitivity and reduces glucose production, supporting steady blood sugar and modest weight loss.
How many tablets per month?
MonthlyEvery 3 months
30 tabletsper month
You'll receive 30 tablets per month. $99 billed monthly. Cancel anytime.
Real prices from our pharmacy. Longer plans cost less per month and are billed up front. Pause or cancel anytime.
- Improves insulin sensitivity and glucose metabolism
- Supports steady blood sugar and energy
- Modest weight loss in most users
Every plan includes
- Personalized, physician-guided plan
- 30 tablets per month, monthly and 3-month
- Dispensed by a US-licensed compounding pharmacy
- Unlimited protocol adjustments and messaging
- Ongoing support and check-ins
- Pause or cancel anytime
- Reviewed by our in-house physicians
- Physician-guided care
- Ongoing, expert support
- 100% online
- Free, discreet shipping
What is Metformin?
(biguanide, oral antidiabetic)
Metformin is an oral medication approved for diabetes that improves how your body uses insulin and regulates blood glucose. Off-label use for weight loss is based on its effects on metabolic health and insulin resistance.
- How it is taken
- Taken by mouth
- How often
- Once a day
- Dose range
- 1–500 mg
- Form
- Weight loss · Oral medication · Metabolic
Modest
average 2–3 kg weight loss over 6 months with diet
Metformin is not a weight-loss drug per se; it improves metabolic function. Weight loss typically comes from improved insulin sensitivity, reduced hunger, and steadier blood sugar. Results vary widely.
How it works,
week by week.
Day 1
A US-licensed physician reviews your health, metabolism, and why an oral medication may help you. Explains the medication's mechanism and what to expect.
Week 1–2
Start your dose. You may feel appetite changes within days, or changes may take weeks. GI effects (metformin) or mood changes (naltrexone) are possible early on.
Weeks 3–6
Your appetite and eating patterns shift. Fullness comes sooner. Your physician checks in and may adjust your dose based on response and tolerability.
Months 2–3
Steady, gradual weight loss. Metabolism and appetite remain improved. Your physician monitors for any side effects and adjusts dosing.
Beyond
Maintenance: your physician works with you to hold results or adjust as your body changes. Long-term monitoring ensures ongoing safety.
What you may notice,
and when.
Weight loss
steady but modest; depends on diet and activity
Appetite change
reduced hunger or improved fullness is common
Energy and metabolism
gradual improvement with weight loss and diet
Medical oversight
your physician monitors for side effects and efficacy
Individual results vary. Benefits reflect what Zepym Health members commonly report to their physician at check-ins; they are not the results of a clinical trial.
Safety first:
what to know before you start.
Important safety information and common side effects
Oral weight-loss medications (metformin, naltrexone, topiramate) have different safety profiles. Metformin: GI side effects (nausea, diarrhea) common, especially initially; not for severe kidney disease. Naltrexone: generally well-tolerated; headache or dizziness possible. Topiramate: cognitive effects ('topiramate fog', difficulty concentrating, word-finding) in 10–15%; kidney stones possible. All are off-label for weight loss; efficacy and safety are not FDA-approved for this use. Tell your physician about all medications, kidney disease, and any history of kidney stones (topiramate). Stop and seek care for severe GI pain (metformin), severe headache, allergic reactions, or eye pain (topiramate).
The research behind
metformin.
Metformin is a diabetes drug used off label for weight. Its best human evidence comes from the Diabetes Prevention Program, which studied people at high risk of diabetes, not people with obesity alone.
- Diabetes31% fewer cases
Diabetes Prevention Program: adults at high risk of diabetes, metformin vs placebo over 2.8 years. Diabetes was 31% less frequent on metformin than on placebo; lifestyle change gave 58%.
DPP, NEJM 2002 - Weight2.06% vs 0.02%
During the DPP, mean weight change was -2.06% on metformin and -0.02% on placebo. Over the unblinded follow-up the gap was 2.0% against 0.2%, and weight loss tracked how much metformin people took.
DPP Outcomes Study, Diabetes Care 2012 - Ten years18% fewer cases
Over 10 years of follow-up, diabetes incidence was 18% lower in the original metformin group than in the original placebo group (95% CI 7 to 28%), and 34% lower in the lifestyle group.
DPP Outcomes Study, Lancet 2009
What the studies found
- Diabetes was 31% less frequent on metformin than on placebo over 2.8 years in adults at high risk (DPP, NEJM 2002).
- Diabetes incidence stayed 18% lower on metformin than on placebo over 10 years (DPP Outcomes Study, Lancet 2009).
- Lowered body weight against placebo, with a mean change of -2.06% against -0.02% during the DPP (DPP Outcomes Study, Diabetes Care 2012).
- The weight loss on metformin was durable for at least 10 years of treatment, and was related to how much of the drug people took (DPP Outcomes Study, Diabetes Care 2012).
Metformin is not approved as a weight-loss drug. The weight figures are small averages from trials run for other goals, and the diabetes benefit was seen in people at high risk, not in people with obesity alone. Compounded or branded weight-loss versions were not studied as such.
What this does not say
- The diabetes figures are relative reductions in people at high risk, not a guarantee for one person.
- Stomach upset was more common on metformin than on placebo; it declined over time (DPP Outcomes Study, Diabetes Care 2012).
- Trials of weight loss in people without diabetes are small and do not agree; a PubMed search turned up no large trial of metformin for weight alone.
The research
behind it.
Metformin improves insulin sensitivity and reduces hepatic glucose production. Studies show modest weight loss (2–3 kg average) in non-diabetic adults, especially those with metabolic syndrome.
Weight loss is gradual and modest; the main benefit is metabolic health, not dramatic fat loss. Best results occur with diet and activity changes.
GLP-1 beyond the scale:
what the research showsHeart, kidneys, liver, sleep and joints: the trials, with their numbers and their limits.Read the researchMicrodosing GLP-1:
what we know, and what we don’tLower doses are everywhere online. Here is what has actually been studied, and how our physicians use dose.Read the research
what the research showsHeart, kidneys, liver, sleep and joints: the trials, with their numbers and their limits.Read the researchMicrodosing GLP-1:
what we know, and what we don’tLower doses are everywhere online. Here is what has actually been studied, and how our physicians use dose.Read the research
Getting started
takes a few minutes.
- 1
Connect with a physician
Answer a few questions online and a US-licensed physician reviews your health, history and goals to make sure treatment is right for you. 100% online. No in-person visit required.
- 2
Get your discreet shipment
If approved, your treatment is compounded by a US-licensed, LegitScript-certified pharmacy, inspected for quality, and shipped discreetly to your door.
- 3
Receive continuous support
Start with one goal, then keep building over time. Unlimited physician messaging, easy refills and dose adjustments, all from the Zepym Health app.
Frequently asked questions
Contact supportHow do I take Metformin?
Taken by mouth, once a day, at bedtime. The starting prescription is 1 tablet (1,000 mg) each time. Your physician sets your own dose and it is printed on your label.
What strengths does Metformin come in?
The pharmacy carries 2: 1,000 mg, 500 mg. Your physician chooses which one you get.
How much arrives in each shipment?
30 tablets at the starting strength, shipped to your door from a licensed US pharmacy.
Is metformin actually for weight loss?
It's off-label for weight loss. Metformin's primary use is diabetes. For weight loss, it works by improving metabolic health and insulin function, supporting modest, steady weight loss. It is not a replacement for semaglutide or tirzepatide.
Why are these off-label?
These medications are FDA-approved for other conditions (diabetes, seizures, addiction) but not specifically for weight loss. Off-label use is legal and common; your physician prescribes based on research and experience.
Which one should I choose?
That depends on your health profile, goals, and what side effects you can tolerate. Metformin is gentlest but least effective. Naltrexone is experimental. Topiramate is moderate. Your physician will recommend based on your individual needs.
Can I combine these with GLP-1 drugs?
Yes, some combinations are used; for example, topiramate plus phentermine. However, combining multiple weight-loss medications requires careful physician oversight.
What if these don't work?
If you see minimal effect after 8–12 weeks, your physician may increase the dose, switch medications, or recommend GLP-1 drugs like semaglutide or tirzepatide for stronger effect.
Metformin educational content reviewed by our physician
Scott Nass, MD Doctor of Medicine, board-certified in Family Medicine
Charles R. Drew University and David Geffen School of Medicine at UCLA. Family Medicine residency at Ventura County Medical Center.
More options
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A weekly dual-action GLP-1/GIP injection for meaningful weight loss and appetite control, paired with glycine for better tolerance.
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Injection
Semaglutide + Glycine
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References
- 1.Metformin and weight loss: a systematic review of non-diabetic use. Obes Surg, 2017
- 2.Topiramate for weight loss: clinical efficacy and safety review. Drugs Today, 2019
Prescription products require an online evaluation with a licensed medical professional who will determine if a prescription is appropriate. Products are compounded by a licensed pharmacy. The FDA has not reviewed or approved compounded products for any use for safety, efficacy, or quality. Compounded medications are not FDA-approved brand-name products.