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The mechanisms by which metformin exerts anorexigenic effects are still emerging, with evidence of direct and indirect effects on the gastrointestinal tract, the gut microbiome, the CNS, and the gut-brain axis ( Metformin health gains versus weight loss The primary rationale for delayed introduction of metformin within AIWG treatment guidelines is limited efficacy in reversing the typically significant burden of weight gain induced by antipsychotic treatment