TITLE: Orlistat, a lipase inhibitor, for weight maintenance after conventional dieting: a 1-y study [see comments]
AUTHORS: Hill JO; Hauptman J; Anderson JW; Fujioka K; O'Neil PM; Smith DK; Zavoral JH; Aronne LJ
AUTHOR AFFILIATION: University of Colorado Health Sciences Center, Denver, USA.
SOURCE: Am J Clin Nutr 1999 Jun;69(6):1108-16
CITATION IDS: PMID: 10357727 UI: 99285732
COMMENT: Comment in: Am J Clin Nutr 1999 Jun;69(6):1059-60
Comment in: Am J Clin Nutr 1999 Jun;69(6):1061-3
ABSTRACT: BACKGROUND: Long-term maintenance of weight loss remains a therapeutic challenge in obesity treatment. OBJECTIVE: This multicenter, double- blind, placebo-controlled study was designed to test the hypothesis that orlistat, a gastrointestinal lipase inhibitor, is significantly more effective than a placebo in preventing weight regain. DESIGN: Obese subjects who lost > or = 8% of their initial body weight during a 6-mo lead-in of a prescribed hypoenergetic diet (4180-kJ/d deficit) with no adjunctive pharmacotherapy were randomly assigned to receive placebo, 30 mg orlistat, 60 mg orlistat, or 120 mg orlistat 3 times daily for 1 y in combination with a maintenance diet to help prevent weight regain. Of 1313 recruited subjects [body mass index (in kg/m2): 28-43], 729 subjects lost > or =8% of their initial body weight during the 6-mo weight-loss lead-in period and were enrolled in the double- blind phase. RESULTS: After 1 y, subjects treated with 120 mg orlistat 3 times daily regained less weight than did placebo-treated subjects (32.8 +/- 4.5% compared with 58.7 +/- 5.8% regain of lost weight; P < 0.001). Moreover, more subjects in the 120-mg orlistat group than in the placebo group regained < or = 25% of lost weight (47.5% of subjects compared with 29.9%). In addition, orlistat treatment (120 mg 3 times daily) was associated with significantly greater reductions in total and LDL-cholesterol concentrations than was placebo (P < 0.001). CONCLUSION: The use of orlistat during periods of attempted weight maintenance minimizes weight readjustment and facilitates long-term improvement in obesity-related disease risk factors.
MAIN MESH HEADINGS: Anti-Obesity Agents/*therapeutic use
Enzyme Inhibitors/*therapeutic use
Lactones/*therapeutic use
Lipase/*antagonists & inhibitors
Obesity/*diet therapy
Obesity/*drug therapy
ADDITIONAL MESH HEADINGS: Adult
Anti-Obesity Agents/administration & dosage
Behavior Therapy
Cardiovascular Diseases/prevention & control
Dietary Fats/administration & dosage
Dose-Response Relationship, Drug
Double-Blind Method
Enzyme Inhibitors/administration & dosage
Female
Human
Lactones/administration & dosage
Lipoproteins, HDL Cholesterol/blood
Male
Risk Factors
Support, Non-U.S. Gov't
Weight Loss/drug effects
PUBLICATION TYPES: CLINICAL TRIAL
JOURNAL ARTICLE
MULTICENTER STUDY
RANDOMIZED CONTROLLED TRIAL
CAS REGISTRY NUMBERS: EC 3.1.1.3 (Lipase)
0 (Anti-Obesity Agents)
0 (Dietary Fats)
0 (Enzyme Inhibitors)
0 (Lactones)
0 (Lipoproteins, HDL Cholesterol)
96829-58-2 (orlistat)
LANGUAGES: Eng

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