What is a common caution with Metformin use for pediatric obesity?

• A. GI intolerance
• B. Weight gain
• C. Hair loss
• D. Increased appetite

Answer: (A)

Gastrointestinal intolerance is the common caution with metformin in pediatric obesity. Diarrhea, abdominal pain, nausea, and vomiting often appear, especially when starting treatment or increasing the dose, and can limit adherence. You can reduce these effects by starting at a low dose and titrating up slowly, taking the medication with meals, and using an extended-release formulation if available. In contrast, weight gain, hair loss, or increased appetite are not typical concerns with metformin; it is more likely to be weight-neutral or associated with modest weight loss in some patients. Also keep in mind rare but serious risks like lactic acidosis, so renal function should be monitored and hydration maintained.