Numerous drugs have been tried in the fight against obesity some affect neurons in the brain, others act on the liver, and one (orlistat, sold as Xenical or Alli) acts to decrease the amount of fat absorbed from the intestinal tract. In a recent meta-analysis, Dr. M. Chilton and colleagues from the University of Leicester in the UK, examined the results of studies on the effect of orlistat on waist circumference of obese people.
While many studies focus on changes in Body Mass Index (BMI) as an indication of treatment effectiveness, these investigators assessed changes in waist circumference because abdominal fat is metabolically active and linked to negative health outcomes. BMI, on the other hand, is more of an indication of overall fatness.
The researchers found that after 6 months of treatment, people who took orlistat had significantly greater decreases in waist circumference (by 2.15 cm) than those who had taken a placebo. There was an even greater difference (by 6.96 cm) between orlistat users and people who received standard care (advice on exercise and lifestyle).
After one year of treatment, in 20 studies, the difference in waist circumference was -2.32 cm, and -2.63 cm for orlistat users compared to placebo and standard care groups respectively.
The results of 39 studies were included in the meta-analysis, most of which were randomized controlled trials. On average, the patients in the studies were 49 years old, two-thirds were women, and 44 percent had been diagnosed with type 2 diabetes. Initially, their waist circumferences averaged 102 cm (42 inches).
ACSH s Dr. Ruth Kava commented Although these changes in waistlines were relatively small, orlistat does seem to be a viable choice for people who need to lose weight. However, use of the drug does not eliminate the need for lifestyle changes if individuals are to increase or maintain these losses.