Drug ± CR

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Hi All,

Combining a pharmacological agent for controlling our calorie intake with mind

control to achieve the same effect may be effective in only individuals.

See the not pdf-available paper abstract below.

Toplak H, Ziegler O, Keller U, Hamann A, Godin C, Wittert G, Zanella MT,

Zuniga-Guajardo S, Van Gaal L.

X-PERT: weight reduction with orlistat in obese subjects receiving a mildly or

moderately reduced-energy diet. Early response to treatment predicts weight

maintenance.

Diabetes Obes Metab. 2005 Nov;7(6):699-708.

PMID: 16219013

Aim: To determine the effect of two different levels of energy deficit on weight

loss in obese patients treated with orlistat. Methods: Patients (n = 430) were

randomized in a 1-year, multicentre, open-label, parallel group study conducted

at

23 hospital centres and university medical departments worldwide. Obese

outpatients

(body mass index 30-43 kg/m(2)) aged 18-70 years with a body weight of >/=90 kg

and

a waist circumference of >/=88 cm (women) or >/=102 cm (men) were treated with

orlistat 120 mg three times daily plus a diet that provided an energy deficit of

either 500 or 1000 kcal/day for 1 year. Orlistat treatment was discontinued in

patients who did not achieve >/=5% weight loss after assessment at 3 and 6

months.

The primary outcome measure was change in body weight from baseline at week 52.

Results: Reported mean difference in energy intake between the two groups

(500-1000

kcal/day deficit) at weeks 24 and 52 was actually 111 and 95 kcal/day

respectively.

Of the 430 patients involved in the study, 295 achieved >/=5% weight loss at

both 3

and 6 months. In this population, at week 52, weight loss from baseline was

similar

for patients randomized to either the 500 or the 1000 kcal/day deficit diet

(-11.4

kg vs. -11.8 kg, respectively; p = 0.778). After 12 months of treatment with

orlistat, 84% (n = 118/141) and 85% (n = 131/154) of patients in the 500 and

1000

kcal/day deficit groups, respectively, achieved >/=5% weight loss, and 50% (n =

70/141) and 53% (n = 82/154) of patients, respectively, achieved >/=10% weight

loss.

Patients in both the diet treatment groups showed similar significant

improvements

in blood pressure, lipid levels and waist circumference at week 52. Conclusions:

Treatment with orlistat was associated with a clinically beneficial weight loss,

irrespective of the prescribed dietary energy restriction (-500 or -1000

kcal/day).

Patients who achieved >/=5% weight loss at 3 months achieved long-term,

clinically

beneficial weight loss with orlistat plus either diet. Therefore, identifying

patients who lose at least 5% weight after 3 months and who maintain this weight

loss up to 6 months is a valuable treatment algorithm to select patients who

will

benefit most from orlistat treatment in combination with diet.

Al Pater, PhD; email: old542000@...

__________________________________

- PC Magazine Editors' Choice 2005

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