Effects of Sibutramine on Resting Metabolic Rate and Weight Loss in Overweight Women

Seagle, Helen M.; Bessesen, Dan; Hill, James O.

doi:10.1002/j.1550-8528.1998.tb00324.x

Cited by 88 publications

(84 citation statements)

References 12 publications

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“…22 This observation taken together with the present ®nding of a weak thermogenic effect of sibutramine emphasises that it may be dif®cult to detect the effect by short-term measurement of EE.…”

Section: Discussionmentioning

confidence: 48%

The effect of sibutramine on energy expenditure and appetite during chronic treatment without dietary restriction

Hansen¹,

Toubro²,

et al. 1999

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OBJECTIVE: To assess the contribution of a thermogenic effect to weight loss induced by eight weeks treatment with sibutramine (15mgad) vs placebo in obese subjects. DESIGN: Randomised, placebo controlled, double blind study. SUBJECTS: Thirty-two (7 male, 25 female) healthy obese body mass index (BMI) 33.9 AE 0.5 kgam 2 subjects completed the trial. MEASUREMENTS: Energy expenditure (EE) was measured by indirect calorimetry during a 32 h stay in a respiration chamber before and after 8 weeks treatment. Visual analogue scales were completed for assessment of appetite sensation. No dietary restriction was given. RESULTS: Sibutramine caused a signi®cant weight loss compared with placebo ( 7 2.4 kg vs 0.3 kg, P`0.001). Despite the larger weight loss after 8 weeks, 24-h EE did not decrease more in the sibutramine than in the placebo group ( 7 2.6% vs 7 2.5%, P ns). When the changes in 24-h EE were adjusted for changes in body weight, 24-h EE decreased signi®cantly less in the sibutramine group than in the placebo group (0.8% vs 3.8%, P`0.02). Sibutramine signi®cantly decreased both hunger and anticipated food consumption, and increased satiety scores. CONCLUSIONS: The weight reducing effect of sibutramine in humans is caused by a dual mechanism: reduction of energy intake by increasing satiety and decreasing hunger and prevention of the decline in EE that follows weight loss.

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Section: Discussionmentioning

confidence: 48%

The effect of sibutramine on energy expenditure and appetite during chronic treatment without dietary restriction

Hansen¹,

Toubro²,

et al. 1999

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“…This effect, however, could result in an elevation in blood pressure and a reduction in the antihypertensive benefits of weight loss. In fact, previous studies in normotensive patients reported elevations in heart rate and blood pressure associated with the use of sibutramine 15 .…”

Section: Discussionmentioning

confidence: 97%

“…Part of the effects of sibutramine is due to the inhibition of noradrenaline reuptake with the resulting maintenance of adrenergic tonus in these patients, which can be beneficial for avoiding the drop in energy expenditure that follows weight loss according to the studies by Hansen et al 14 and Seagle et al 15 . This effect, however, could result in an elevation in blood pressure and a reduction in the antihypertensive benefits of weight loss.…”

Section: Discussionmentioning

confidence: 99%

“…The use of sibutramine is associated with an increase in satiety scores and a lack of decline in 24-hour energy expenditure 14,15 , which make sibutramine efficient in inducing weight loss. Several studies show an adequate tolerability profile for the drug; however, aspects referring to hypertensive patients are still inconclusive, and the presence of higher adrenergic activity may interfere with the benefits resulting from weight loss.…”

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confidence: 99%

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Effects of Sibutramine on the Treatment of Obesity in Patients with Arterial Hypertension

Faria¹,

Filho²,

Lerario³

et al. 2002

Arq. Bras. Cardiol.

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Objective - Effects of Sibutramine on the Treatment of Obesity in Patients with Arterial Hypertension Artigo OriginalThe prevalence of obesity and its associated morbidities has increased in several countries worldwide, including Brazil 1,2 . The increase in body mass index has proved to be a determinant factor for elevation of blood pressure, both for obese and nonobese children and adults 3,4 . In addition, the presence of obesity is related to a 2.5 higher risk of arterial hypertension, mainly in patients with central body fat distribution 5 . Several hypotheses exist for the pathophysiology of arterial hypertension in this obese population. The first and more accepted hypothesis proposes that hyperinsulinemia secondary to insulin resistance existing in these patients leads to greater sympathetic activity and to renal sodium retention, which would account for the increase in pressure levels [6][7][8] . The second hypothesis associates the arterial hypertension existing in these patients with the mechanical compression of renal parenchyma by visceral fat. This leads to hyperactivation of the renin-angiotensinaldosterone system (RAAS), higher sodium reabsorption, and a subsequent elevation in blood pressure by a mechanism independent from insulinemia 9,10 .Even though we have not reached a consensus about the causes of arterial hypertension in the obese, several clinical studies confirm the importance of weight loss to better control blood pressure levels 11,12 .The great challenge has been to find effective clinical treatments, which do not impair blood pressure control, to induce weight loss in hypertensive patients. Of the several treatments available for weight control, we can count on appetite suppressing drugs, which comprise a generic class of drugs derived from amphetamines that act through adrenergic receptors, and, therefore, may aggravate hypertension. More recently, other options include orlistat that inhibits gastrointestinal fat absorption, and sibutramine, an appetite suppressant that blocks serotonin, dopamine, and noradrenaline reuptake 13 .The use of sibutramine is associated with an increase in satiety scores and a lack of decline in 24-hour energy

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“…20,21 Increase in energy expenditure with sibutramine treatment has been reported in two studies 19,20 Journal of Human Hypertension although not in one other. 22 This possible dual mechanism of action may enhance the efficacy of sibutramine by diminishing the decrease in metabolic rate normally encountered upon initial weight loss. Because the cardiovascular side effects of sibutramine can be attributed, in part, to stimulation of the sympathetic nervous system, blocking of the cardiac ␤ 1 -adrenoceptors with ␤-blockers can be expected to reduce the magnitude of these effects.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of sibutramine for weight loss in obese patients with hypertension well controlled by β-adrenergic blocking agents: a placebo-controlled, double-blind, randomised trial

et al. 2002

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Sibutramine is a serotonin-noradrenaline reuptake inhibitor that is effective for long-term weight reduction and maintenance in obese patients when used as an adjunct to dietary and behavioural measures. Because the inhibition of noradrenaline reuptake may be expected to increase systolic and diastolic blood pressure (SBP and DBP) and pulse rate (PR), a 12-week multi-centre, placebo-controlled, double-blind study was designed to evaluate the efficacy and tolerability of sibutramine for weight loss in obese patients whose hypertension was well controlled (DBP р95 mm Hg) by ␤-adrenergic blocking agents (␤-blockers), with or without concomitant thiazide diuretics. Of the 61 patients randomised to sibutramine 20 mg once daily or placebo, 55 patients (90%) completed the study. After 12 weeks, sibutramine-treated patients lost significantly more weight than placebo-treated patients: mean weight reductions were 4.2 kg (4.5%) in the sibutramine group vs 0.3 kg (0.4%) in the placebo group (P Ͻ0.001). Greater weight reduction on sibutramine was accompanied by trends for greater mean reductions in serum triglycerides and very low density lipoprotein cholesterol. Sibutramine was well tolerated, and most adverse events were mild or moderate in severity. No sibutramine patient discontinued treatment because of an adverse event. Mean supine and standing DBP and SBP were not

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Effects of Sibutramine on Resting Metabolic Rate and Weight Loss in Overweight Women

Cited by 88 publications

References 12 publications

The effect of sibutramine on energy expenditure and appetite during chronic treatment without dietary restriction

The effect of sibutramine on energy expenditure and appetite during chronic treatment without dietary restriction

Effects of Sibutramine on the Treatment of Obesity in Patients with Arterial Hypertension

Efficacy and safety of sibutramine for weight loss in obese patients with hypertension well controlled by β-adrenergic blocking agents: a placebo-controlled, double-blind, randomised trial

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