Does Jardiance cause weight loss?

Jardiance is not approved for weight loss, but it’s used off label for weight loss in people with Type 2 diabetes and cardiovascular risk

By Georgia C. Yalanis, MD | Jun. 10, 2022 Medically reviewed by Keith Gardner, R.Ph.

Does Jardiance cause weight loss? | How does Jardiance work for weight loss? | Who can take Jardiance for weight loss? | Alternatives to Jardiance for weight loss | Maximizing Jardiance benefits

Living with Type 2 diabetes mellitus can be challenging. Many people with Type 2 diabetes are also overweight or have other medical conditions. As such, weight loss is often targeted when beginning any type of lifestyle changes and drug treatment to lower blood sugar levels.

Jardiance (empagliflozin) is a sodium-glucose co-transporter 2 (SGLT2) inhibitor that has been FDA-approved to improve blood sugar, or glucose, levels in individuals with Type 2 diabetes. SGLT2 inhibitors, like Jardiance and similar drugs such as Invokana ( canagliflozin) and Farxiga (dapagliflozin), are a class of diabetes drugs that lower blood glucose by causing the kidneys to remove sugar from the body through the urine. Weight loss can be an effect of SGLT2 inhibitors. In this article, we’ll discuss Jardiance and weight loss: its efficacy, safety, and alternatives.

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Does Jardiance cause weight loss?

Jardiance does cause weight loss.

A stable weight is maintained by the balance of caloric, or food, intake and energy expenditure, such as when exercising. In Type 2 diabetes an excess of calories, in the form of glucose, can lead to fat deposition around the internal organs,such as the liver and pancreas, and in muscle tissue. A key objective during diabetic weight loss is to maximize the loss of body fat while minimizing the loss of lean tissue such as muscle.

There is some variability regarding the amount of SGLT2 inhibitor-induced weight loss seen in controlled clinical studies. Clinical trial data published in The Lancet shows a 5.5- to 8.82-pound weight loss in participants over the course of a 104-week trial.

“Generally, in practice we see four to eight pounds of weight loss on average,” says Stephanie Redmond, Pharm.D., a pharmacist who specializes in diabetes care and management. “Some patients would be ‘hyper-responders’’ and see much more.”

While four to eight pounds may not seem like a substantial amount of weight loss, it is important to note that according to the American Diabetes Association’s (ADA) Diabetes Prevention Program, every two pounds of weight loss is associated with a significant reduction in the likelihood of progressing to Type 2 diabetes. For people with Type 2 diabetes, even modest reductions in weight have significant health benefits beyond improving blood glucose levels.

It is also important to note that the weight loss variability seen among patients in clinical studies cannot be fully explained by the effects of Jardiance alone. Other factors that contribute to weight loss include genetic predisposition, access to and types of food eaten, and exercise regimen and frequency.

How does Jardiance work for weight loss?

Jardiance is an oral antihyperglycemic medication with a unique mechanism of action that can lower blood glucose levels independent of the effects of insulin. Sodium-glucose cotransporters are responsible for glucose reabsorption in the kidney. SGLT2 inhibitors, such as Jardiance, block these transporters, so excess glucose is not reabsorbed into the bloodstream and is instead excreted out in the urine. This mechanism of action is responsible for unique side effects of Jardiance, which may include urinary tract infections, female genital yeast infections, and necrotizing fasciitis, a rare but serious bacterial infection that causes damage to the tissue under the skin in the area between the anus and genitals (the perineum) in males and females.

Jardiance is not an appetite suppressant, i.e., it does not make one feel less hungry. Instead, SGLT2 inhibitors promote an average of 75 grams of glucose excretion in the urine per day, which is about 300 excess calories. A loss of 300 calories per day would result in a little over one pound of weight loss per week.

Who can take Jardiance for weight loss?

Jardiance has been FDA-approved as a supplement to diet and exercise for adults with Type 2 diabetes. Jardiance is available in two strengths: 10 mg and 25 mg tablets. The starting dosage is 10 mg taken once daily in the morning. The dosage of Jardiance may be increased to 25 mg taken once per day for additional blood glucose control in individuals who have been tolerating the medication well.

There is no approved Jardiance dosage for weight loss. The change from 10 mg to 25 mg should not be made to accelerate or promote weight loss but only to safely lower high blood sugar in certain individuals.

There are no clinical studies describing the off-label use of Jardiance for weight loss. However, with obesity affecting up to 500 million people worldwide, and only seven drugs approved by the FDA to treat obesity, healthcare providers are turning to off-label drug use for their patients. Until more medications are approved for long-term use, healthcare providers will likely continue to prescribe any medications that may be helpful for their patients in need.

While a modest weight loss may be statistically significant to improve health status, it is usually far from satisfactory to meet the overall needs and desires of most individuals who need or want to lose weight. If Jardiance is used off-label for weight loss, it is important to follow medical advice and be mindful of side effects while taking the medication. Due to possible side effects, the FDA recommends that Jardiance should not be used or should be used with extreme caution in those with the following conditions:

Type 1 diabetes (may increase the risk of diabetic ketoacidosis)
Impaired renal function
Those at risk for dehydration
Hypersensitivity to the medication or to any components of the medication
Are pregnant, plan to become pregnant, or are breastfeeding

Other diabetic medications that cause weight loss

Several medications that are used in diabetes management promote weight loss through various mechanisms. These medications may be used alone as monotherapy or in combination therapy with other medications, depending on an individual’s blood glucose control.

Metformin

Metformin, a medication in the biguanide class, is often the first-line medication used in the treatment of Type 2 diabetes. Metformin-associated weight loss occurs via several mechanisms including reduction of glucose production in the liver, reduction in insulin production, and changes in appetite, In a Diabetes Prevention Program randomized controlled trial, 28.5% of individuals taking metformin lost 5% or more of their body weight after one year of treatment.

Liraglutide

Liraglutide is glucagon-like peptide-1 (GLP-1) receptor agonists. GLP-1 receptor agonists mimic the structure of naturally occurring hormones in the body called incretins. GLP-1 receptor agonists stimulate the release of insulin from the pancreas in response to a meal. This helps reduce the amount of circulating glucose in the blood. GLP-1 receptor agonists also slow gut motility, which leaves food in the digestive tract longer which increases the feeling of being full.

Liraglutide is used to treat Type 2 diabetes and for non-diabetic weight loss. It is sold under the brand names Victoza and Saxenda. Victoza is a lower dose of medication used in the management of Type 2 diabetes. Saxenda is a higher dose of medication that has been FDA-approved for weight loss in obesity. In evaluation of more than 3,000 patients, adding liraglutide to lifestyle counseling resulted in a 6.9- to 13.3-pound greater weight loss, which was also demonstrated to be sustained after two years.

Trulicity

Trulicity (dulaglutide) is also a GLP-1 receptor agonist FDA-approved for the treatment of Type 2 diabetes, along with diet and exercise. Although not FDA-approved for weight loss, the results of the AWARD-11 clinical trial show that the weight loss effects from Trulicity occur in a dose- and body mass-dependent fashion. Individuals taking the highest doses of the medication and those with the highest BMI lost the most weight.

Semaglutide

Semaglutide is manufactured under the brand name Ozempic for Type 2 diabetes management and the brand name Wegovy when used exclusively for weight loss. Semaglutide is a GLP-1 receptor agonist administered in an injectable pen that is dosed once per week. In the STEP-4 randomized clinical trial, individuals taking semaglutide lost an average of 10% of their body weight in a 20-week period.

Invokana

Invokana (canagliflozin) and Jardiance are both SGLT2 inhibitors with comparable mechanisms of action and common side effect profiles. While both medications are associated with statistically significant weight loss, in a systematic review of separate clinical studies Invokana users experienced slightly more weight loss than Jardiance users for any dosage administered.

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How to maximize Jardiance benefits

Medications that are used to treat Type 2 diabetes should be used in addition to significant lifestyle changes including strategies to lower weight and increase exercise and exercise tolerance. According to the ADA, SGLT2 inhibitors improve blood glucose control, lower body weight, improve associated weight-related medical conditions, and lower blood pressure. In individuals with known cardiovascular disease or kidney impairment, SGLT2 inhibitors can also help prevent cardiovascular death from heart attack or heart failure and stabilize some forms of kidney disease. While these medications are extremely useful in diabetes care, they are also associated with very serious side effects including life-threatening hypoglycemia (low blood sugar) and should be used carefully while following the medical advice given by a healthcare provider.

Proper compliance is required to obtain the maximum Jardiance weight loss effects. Jardiance should be taken every day in the morning, with or without food.
Be aware of other diabetes medications you are taking that may counteract desired weight loss by causing weight gain such as some sulfonylureas, thiazolidinediones, and insulin.
Take all other prescribed medications that improve weight-related comorbidities such as cholesterol-lowering agents, kidney protective agents, and medications to reduce the risk of heart disease.
There is substantial data demonstrating that low-calorie diets and short-term use of very low-calorie diets are extremely beneficial to individuals with Type 2 diabetes. Speak with your healthcare provider about these types of diets and how to implement them safely.
Exercising regularly is known to increase the rate of fat oxidation and provide protection against all-cause mortality in individuals with Type 2 diabetes. Regular, intense (as one can tolerate) periods of exercise should be performed by all people with Type 2 diabetes.
When weight loss is a primary goal, and for all individuals with Type 2 diabetes, alcohol consumption should be limited. Alcohol is processed by the body as sugar, is stored as fat, and binge drinking contributes to insulin resistance.