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Resistance training is the most effective method to increase skeletal muscle mass and strength in the elderly; however, the response in older individuals is variable and sometimes completely absent. We hypothesized that metformin would augment elderly participants’ response to training. At two study sites, participants were randomized to metformin or placebo and all performed resistance training for 14 weeks. Ninety-four participants completed the study and results were analyzed per-protocol. DXA showed that lean mass increased overall (P< 0.0001), with the metformin group gaining significantly less lean mass than the placebo group (P< 0.01). Similarly, thigh CT scans indicated that the metformin group gained less (normal density) muscle than placebo (P< 0.01). RNAseq analyses suggest that metformin may blunt training-induced changes in muscle gene expression. These data indicate that adjuvant …