Does Jardiance (Empagliflozin) cause weight gain?

Does Jardiance Cause Weight Gain?

No, Jardiance (empagliflozin) does not cause weight gain but actually promotes weight loss in patients with type 2 diabetes. 1, 2

Mechanism of Action and Weight Effects

Jardiance belongs to the class of sodium-glucose cotransporter 2 (SGLT2) inhibitors, which work by:

• Reducing glucose reabsorption in the kidneys
• Increasing urinary glucose excretion
• Causing direct caloric loss through glycosuria 3

Evidence of Weight Loss

Clinical trials consistently demonstrate that Jardiance leads to weight reduction:

• FDA label data shows weight reduction of 1.8-2.4% from baseline compared to placebo 1
• In 24-week studies, Jardiance produced an adjusted mean weight loss of 2.08-2.46 kg compared to 0.45 kg with placebo 4
• Empagliflozin reduces not only overall weight but also waist circumference and indices of adiposity 2

Comparison to Other Diabetes Medications

When choosing glucose-lowering medications for patients with diabetes and weight concerns, it's important to understand how different agents affect body weight:

Medications associated with weight loss:

• SGLT2 inhibitors (like Jardiance/empagliflozin) 3
• GLP-1 receptor agonists 3
• Metformin 3
• Amylin mimetics 3

Weight-neutral medications:

• Dipeptidyl peptidase 4 inhibitors 3
• Alpha-glucosidase inhibitors 3

Medications associated with weight gain:

• Insulin secretagogues (sulfonylureas and meglitinides) 3
• Thiazolidinediones 3
• Insulin 3

Clinical Implications

The weight loss effect of Jardiance provides additional benefits beyond glycemic control:

• Modest reductions in blood pressure 5, 4
• Improvements in cardiovascular risk factors 5
• Potential benefits for patients with heart failure 6

Practical Considerations

When using Jardiance:

• Weight loss is typically observed within the first weeks of therapy 4
• The weight reduction effect persists with long-term treatment 1
• The magnitude of weight loss appears to be dose-dependent 1
• Weight loss may be more pronounced when Jardiance is used as monotherapy compared to combination therapy 1

Potential Side Effects

While Jardiance does not cause weight gain, be aware of its common side effects:

• Urinary tract infections
• Genital mycotic infections
• Volume depletion (particularly in elderly patients or those on diuretics)

Summary

For patients with type 2 diabetes concerned about weight gain, Jardiance (empagliflozin) is an excellent medication choice as it consistently promotes modest weight loss while improving glycemic control. Current diabetes treatment guidelines specifically recommend prioritizing medications with beneficial effects on weight, such as SGLT2 inhibitors, for patients with diabetes and overweight/obesity 3.