The way it was finally explained to me:
AP's interrupt the nerve impulses going from your stomach to your brain. Therefore, your brain does not get the signal that you are full so you are hungry all the time.
Now that we know this, how can reverse it amd still stay on medication? I have no idea.
BUT....metformin taken daily has proved to open up that line of communication between the brain and stomach pretty well in some individuals. My daughter took it for a while and it worked very well. She lost most of the 40 lbs she gained. Then medicaid denied her coverage of metformin because there was not enough proof yet of this helping. Now she is putting the weight back on again.

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