Published: 2020-10-28

The clinical efficacy of orlistat in the treatment of obesity

Hande Peynirci


Background: The prevalence of obesity is gradually increasing worldwide and reaches an epidemic extent. Currently, treatment of obesity with pharmacological options has gained importance due to the frequent failure of lifestyle changes. Anti-obesity medications have an unfortunate history that make many clinicians uncomfortable with their prescription. In this study, we aimed to examine the effect of orlistat on weight loss and glycaemic parameters.

Methods: Forty patients under orlistat treatment between November 2017 to October 2018 were recruited and their weight, body mass index (BMI), glucose, insulin, and the homeostatic model assessment of insulin resistance (HOMA-IR) values were recorded before and after treatment. Patients aged >18 years with BMI≥40 kg/m2 were enrolled to the study while having the diagnosis of diabetes mellitus, those with gastrointestinal diseases, who were pregnant or in lactation period, using drugs that have an effect on weight, and who did not come their follow-up after 12 weeks were excluded.

Results: Thirty-four patients were female, 6 were male, and the mean age was 42.75±10.60 years. The mean height found as 161.10±8.98 cm. Before treatment, the mean weight was 120.62±16.56 kg, BMI was 46.43±4.61 kg/m2, and HOMA-IR was 5.84±3.58. After 12 weeks, it was observed that the mean weight decreased to 112.67±16.21 kg, BMI to 43.35±4.55 kg/m2, and HOMA-IR to 3.73±2.38. There was a statistically significant difference in these parameters compared to the pre-treatment values.

Conclusions: Given the lack of non-surgical treatments, orlistat can provide significant benefits in the current clinical practice when combined with the appropriate diet.


Insulin resistance, Pharmacotherapy, Obesity, Orlistat, Weight loss

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Apovian CM, Aronne LJ, Bessesen DH, McDonnell ME, Murad MH, Pagotto U, et al. Pharmacological management of obesity: an endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2015;100(2):342-62.

Ness-Abramof R, Nabriski D, Apovian CM. Medical therapy for obesity: present and future. Isr Med Assoc J. 2004;6(12):760-5.

GBD 2015 Obesity Collaborators, Afshin A, Forouzanfar MH, Reitsma MB, Sur P, Estep K, et al. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N Engl J Med. 2017;377(1):13-27.

Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9945):766-81.

Satman I, Yilmaz T, Sengül A, Salman S, Salman F, Uygur S et al. Population-based study of diabetes and risk characteristics in Turkey: results of the turkish diabetes epidemiology study (TURDEP). Diabetes Care. 2002;25(9):1551-6.

Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N et al. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol. 2013;28(2):169-80.

Obesity: preventing and managing the global epidemic: report of a WHO consultation, Geneva, 3-5 June 1997 WHO: Geneva. Available at: Accessed on 3 August 2020.

Connolly HM, Crary JL, McGoon MD, Hensrud DD, Edwards BS, Edwards WD et al. Valvular heart disease associated with fenfluramine-phentermine. N Engl J Med. 1997;337(9):581-8.

Heck AM, Yanovski JA, Calis KA. Orlistat, a new lipase inhibitor for the management of obesity. Pharmacotherapy. 2000;20(3):270-9.

Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol. 2014;63(25 Pt B):2985-3023.

Trouillot TE, Pace DG, McKinley C, Cockey L, Zhi J, Häeussler J et al. Orlistat maintains biliary lipid composition and hepatobiliary function in obese subjects undergoing moderate weight loss. Am J Gastroenterol. 2001;96 (6):1888-94.

Drent ML, van der Veen EA. Lipase inhibition: a novel concept in the treatment of obesity. Int J Obes Relat Metab Disord. 1993;17(4):241-4.

Bloch KV, Salles GF, Muxfeldt ES, Da Rocha Nogueira A. Orlistat in hypertensive overweight/obese patients: results of a randomized clinical trial. J Hypertens. 2003;21(11):2159-65.

Torgerson JS, Hauptman J, Boldrin MN, Sjöström L. XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Diabetes Care. 2004;27(1):155-61.

Ozkan Y, Akbulut M, Donder E. The Effect of Orlistat Treatment on Weight Loss and Lipid Profiles With Obese Individuals. Fırat Uni J Heal Sci. 2000;14:331-4.

Kaya A, Aydin N, Topsever P, Filiz M, Oztürk A, Dağar A et al. Efficacy of sibutramine, orlistat and combination therapy on short-term weight management in obese patients. Biomed Pharmacother. 2004;58(10):582-7.

Pagotto U, Vanuzzo D, Vicennati V, Pasquali R. Pharmalogical therapy of obesity. G Ital Cardiol (Rome). 2008;9(4 Suppl 1):83S-93.

Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393-403.

Lindström J, Louheranta A, Mannelin M, Rastas M, Salminen V, Eriksson J et al. The Finnish Diabetes Prevention Study (DPS): Lifestyle intervention and 3-year results on diet and physical activity. Diabetes Care. 2003;26(12):3230-6.

Lloret-Linares C, Greenfield JR, Czernichow S. Effect of weight-reducing agents on glycaemic parameters and progression to Type 2 diabetes: a review. Diabet Med. 2008;25(10):1142-50.

Orlistat HJ. Selective inhibition of caloric absorption can affect long-term body weight. Endocrine. 2000;13(2):201-6.