Which of the following diabetes drugs is associated with weight loss?

Metformin is recognized for its ability to promote weight loss or at least weight neutrality in patients with type 2 diabetes. It works primarily by improving insulin sensitivity, reducing hepatic glucose production, and decreasing intestinal absorption of glucose. These mechanisms can lead to a reduction in appetite and a slight decrease in body weight.

In contrast, other diabetes medications listed tend to be associated with weight gain. Pioglitazone, for example, is a thiazolidinedione that can cause fluid retention and weight gain due to its mechanism of action, which increases insulin sensitivity but can also lead to changes in fat distribution. Sulfonylureas stimulate insulin secretion from the pancreas, which may lead to increased appetite and subsequent weight gain. Insulin therapy can also result in weight gain as it promotes the storage of glucose and fat, and patients may eat more when they notice a drop in blood glucose levels.

Thus, Metformin stands out as the diabetes medication linked to weight loss, making it a favorable option for patients who also need to manage weight alongside their diabetes.