Metformin has pleiotropic effects but is generally considered to serve as a net “insulin sensitiser” in conditions of ectopic adiposity with insulin resistance; in addition, it raises AMPK activity, and the circulating concentrations of Growth-and-Differentiation Factor 15 (GDF15), a peptide hormone that reduces hepatic steatosis and raises intestinal glucose utilization thereby promoting weight loss [59–61]. Here, GDF15 is linked to fatty liver disease.