Orlistat, Sibutramine, or Combination Therapy: Which Performs Better on Waist Circumference in Relation with Body Mass Index in Obese Patients?

Abstract

The aim of this study was to evaluate decrease in waist circumference in obese patients receiving different anti-obesity treatments. The study was designed as a short-term (12 weeks), open-label, and randomized trial. Eighty six patients (70 females, 81.4%; mean age 41.09±8.73 years, mean BMI 36.1±4.3 kg/m 2 ) were randomized to four different therapy groups. The primary outcome parameters were waist circumference and body mass index (BMI). The therapy groups were a) diet+sibutramine 1×10 mg/d (n=22), b) diet+orlistat 3× 120 mg/d (n=25), c) combination of diet+sibutramine+orlistat (n=20) and d) diet (n=19). Combination therapy was more effective than diet and orlistat mono-therapy (p<0.0001 for all), but not significantly superior to sibutramine mono-therapy (p=0.072) in decreasing BMI. Sibutramine mono-therapy was significantly more effective in inducing BMI decrease compared with orlistat mono-therapy (p=0.039). The association between change in BMI and change in waist circumference was strongest in the orlistat mono-therapy group (P interaction=0.003). This means that patients taking orlistat experienced more decrease in waist circumference (3.4 cm, R 2 =0.29) per unit decrease in BMI compared to patients under combination therapy (2.6 cm, R 2 =0.25, P interaction = 0.015) and patients taking sibutramine (1.8 cm, R 2 =0.19, P interaction=0.026). In the diet therapy group decline in waist circumference was independent of BMI (1.9 cm, R 2 =0.02, P interaction=0.076). Although combination therapy and sibutramine mono-therapy were more effective in

Exercise Training as an Adjunct to Orlistat Therapy Reduces Oxidative Stress in Obese Subjects

“…In the present study, orlistat therapy combined with a dietary prescription helped patients to loss 8.5% of body weight and 13.2% of fat mass, which are comparable with report of previous short-term studies (Van Gaal et al 1998;Aydin et al 2004). One may expect that the achieved amount of weight loss during study period is in medically accepted optimal ranges and is often sufficient to reduce obesity related risk factors (Lindgarde 2000;Mertens and Van Gaal 2000).…”

Tackling obesity: new therapeutic agents for assisted weight loss

“…Sibutramine and the combination therapy were equally effective in reducing BMI, and were both significantly more effective than orlistat therapy alone. 74 Similar findings were reported by other investigators as well. [74][75][76] rimonabant (Acomplia ® )…”

“…74 Similar findings were reported by other investigators as well. [74][75][76] rimonabant (Acomplia ® )…”

Orlistat: current status in clinical therapeutics

“…The relatively straightforward GI based means of action of the medication makes it an ideal combination agent for use with other anti-obesity medications in the right setting with the intent of further increasing associated weight loss [9,[135][136][137][138][139][140][141]. It must, however, be acknowledged that to date the available data on orlistat combination therapy with sibutramine has shown little substantive weight loss benefit compared to sibutramine alone [142][143][144][145]. This may, however, be related to the relatively small sample size of these trials and their relatively short duration.…”