Empagliflozin, known by its brand name Jardiance, is a prescription medication primarily used to manage blood sugar levels. It has also gained attention for its observed effect on weight. This medication often leads to modest weight loss as a secondary benefit, whether used alone or with other glucose-lowering therapies.
How Empagliflozin Promotes Weight Loss
Empagliflozin functions as a sodium-glucose cotransporter 2 (SGLT2) inhibitor, a class of drugs that targets the kidneys. The kidneys typically reabsorb most of the glucose filtered from the blood back into the bloodstream. SGLT2 inhibitors block the action of the SGLT2 protein in the renal tubules, which is responsible for this reabsorption process. By inhibiting SGLT2, empagliflozin causes the kidneys to excrete a greater amount of glucose into the urine.
This increased urinary glucose excretion results in a loss of calories from the body, as glucose contains energy. Studies have shown that SGLT2 inhibitors can lead to the elimination of approximately 60 to 100 grams of glucose per day in the urine, contributing to a caloric deficit. Beyond this direct caloric effect, research suggests empagliflozin may also influence energy metabolism by promoting fat utilization and enhancing energy expenditure.
Expected Weight Loss and Patient Eligibility
Clinical trials show empagliflozin leads to a modest reduction in body weight. Patients typically experience an average weight loss of around 1.5 to 2 kilograms compared to placebo. Some studies report reductions ranging from 1.4 to 2.1 kg over shorter periods, with others indicating an average decrease of 2.96 kg (3.8%) over three months. This weight loss often involves a reduction in both subcutaneous and visceral fat.
Empagliflozin is not primarily prescribed for weight loss, but for its established benefits in specific medical conditions. The FDA has approved empagliflozin for:
- Improving glycemic control in adults and pediatric patients aged 10 years and older with type 2 diabetes mellitus, as an adjunct to diet and exercise.
- Reducing the risk of cardiovascular death in adults with type 2 diabetes and established cardiovascular disease.
- Reducing the risk of cardiovascular death and hospitalization for heart failure in adults with heart failure.
- Reducing the risk of sustained decline in estimated glomerular filtration rate (eGFR), end-stage kidney disease, cardiovascular death, and hospitalization in adults with chronic kidney disease at risk of progression.
Potential Side Effects and Usage Guidelines
Empagliflozin can lead to certain side effects. Common side effects include increased frequency of urination, as the drug promotes fluid excretion. Due to increased glucose in the urine, patients may also experience a higher incidence of genital yeast infections and urinary tract infections. Women might notice vaginal discharge, itching, or odor, while men could experience redness, itching, swelling, or pain around the penis.
Dehydration is a possibility, especially if individuals are taking diuretics, are on a low-salt diet, have kidney problems, or are 65 years of age or older. Symptoms of dehydration include increased thirst, dry mouth, dizziness, lightheadedness, or feeling weak. Patients should maintain adequate hydration, typically 6-8 glasses of water daily. Diabetic ketoacidosis, a serious condition where harmful substances called ketones build up in the body, is another potential side effect, even with normal blood sugar levels. Symptoms can include nausea, vomiting, stomach pain, and unusual tiredness.
Empagliflozin is a prescription medication not intended as a standalone weight loss drug for individuals without its primary indications. It is crucial to consult a healthcare professional before starting or stopping this medication. Medical supervision is necessary to monitor for potential side effects, assess kidney function, and ensure proper usage based on an individual’s specific health conditions and needs.