What is a primary purpose of metformin in obese patients?

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In obese patients, the primary role of metformin is to improve glycemic control while helping prevent further weight gain. Metformin lowers hepatic glucose production and improves peripheral insulin sensitivity, which helps reduce blood glucose without promoting hypoglycemia. Unlike some therapies that can cause weight gain, metformin is weight-neutral or can even lead to modest weight loss in some individuals, making it a favorable choice for patients who are already overweight or obese. It is not a weight-loss drug through appetite suppression, not a medication that increases hepatic glucose production, and it does not replace insulin in all patients—many with type 2 diabetes start with metformin but may still require other therapies if needed.