Which of the following is NOT listed as a medication associated with weight gain in pediatric populations?

• A. Metformin
• B. Insulin
• C. Paroxetine
• D. Steroids

Answer: (A)

Weight gain from medications in children often comes from drugs that affect appetite, fluid balance, or fat distribution. Steroids commonly cause weight gain through increased appetite and fluid retention, while insulin promotes energy storage, leading to gradual weight gain in youths with diabetes. Paroxetine, an antidepressant, can also be associated with increased appetite and weight gain in some pediatric patients. Metformin, however, works by reducing hepatic glucose production and improving insulin sensitivity; in children it is typically weight-neutral or can even lead to modest weight loss, especially when used for insulin resistance or polycystic ovary syndrome. Because metformin does not tend to cause weight gain, it is the correct choice.