title: Review article: malnutrition and maltreatment--a comment on orlistat for the treatment of obesity.
abstract: The prevalence of obesity has doubled in the last 10 years and is now reaching epidemic proportions. There is a significant comorbidity and financial cost associated with this disorder. Orlistat is an intestinal lipase inhibitor that is approved for the treatment of obesity. Recent randomized, double-blind, placebo-controlled trials have demonstrated the benefit of orlistat used in conjunction with a hypocaloric (low-fat) diet in facilitating weight reduction and the long-term maintenance of this weight loss. Patients treated with orlistat lost a greater amount of initial body weight compared to those who received placebo. After 24 months of treatment, weight loss of more than 5% was maintained in a greater number of those treated with orlistat. This was associated with significant reductions in cardiovascular risk factors (cholesterol, LDL cholesterol, LDL:HDL cholesterol ratio). The main adverse events are related to fat malabsorption, with potential losses of fat-soluble vitamins and other compounds. Orlistat as a treatment for obesity, when prescribed within present guidelines, can aid modest weight loss in about one-third of patients. More importantly, it can assist in the maintenance of weight loss with major medical benefits for these patients.
authors.affiliation: Department of Human Nutrition, Royal Infirmary, Glasgow, Scotland.
authors.forename: A
authors.initials: A
authors.lastname: Cahill
authors.forename: M E
authors.initials: ME
authors.lastname: Lean
mesh_terms: D019440:Anti-Obesity Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007783:Lactones / Q000008:administration & dosage / Q000627:therapeutic use*; D009748:Nutrition Disorders / Q000150:complications / Q000188:drug therapy*; D009765:Obesity / Q000188:drug therapy* / Q000209:etiology; D000077403:Orlistat
chemical_list: D019440:Anti-Obesity Agents; D007783:Lactones; D000077403:Orlistat