The effect of sibutramine on energy expenditure and appetite during chronic treatment without dietary restriction.
OBJECTIVE
To assess the contribution of a thermogenic effect to weight loss induced by eight weeks treatment with sibutramine (15mg/d) vs placebo in obese subjects.


METHODS
Randomised, placebo controlled, double blind study.


METHODS
Thirty-two (7 male, 25 female) healthy obese body mass index (BMI) 33.9+/-0.5 kg/m2 subjects completed the trial.


METHODS
Energy expenditure (EE) was measured by indirect calorimetry during a 32 h stay in a respiration chamber before and after 8 weeks treatment. Visual analogue scales were completed for assessment of appetite sensation. No dietary restriction was given.


RESULTS
Sibutramine caused a significant weight loss compared with placebo (-2.4 kg vs+0.3 kg, P<0.001). Despite the larger weight loss after 8 weeks, 24-h EE did not decrease more in the sibutramine than in the placebo group (-2. 6% vs -2.5%, P=ns). When the changes in 24-h EE were adjusted for changes in body weight, 24-h EE decreased significantly less in the sibutramine group than in the placebo group (0.8% vs 3.8%, P<0.02). Sibutramine significantly decreased both hunger and anticipated food consumption, and increased satiety scores.


CONCLUSIONS
The weight reducing effect of sibutramine in humans is caused by a dual mechanism: reduction of energy intake by increasing satiety and decreasing hunger and prevention of the decline in EE that follows weight loss.
Hansen
D L
DL
Research Department of Human Nutrition, The Royal Veterinary and Agricultural University, Rolighedsvej 30, Frederiksberg C, Denmark. ast@kvl.dk
Toubro
S
S
Stock
M J
MJ
Macdonald
I A
IA
Astrup
A
A
D000328:Adult; D001067:Appetite Depressants / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D001823:Body Composition / Q000187:drug effects; D002153:Calorimetry, Indirect; D003503:Cyclobutanes / Q000494:pharmacology*; D004311:Double-Blind Method; D004734:Energy Metabolism / Q000187:drug effects*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006815:Hunger / Q000187:drug effects; D008297:Male; D009765:Obesity / Q000188:drug therapy / Q000378:metabolism*; D010919:Placebos; D012527:Satiation / Q000187:drug effects; D013997:Time Factors; D015431:Weight Loss
D001067:Appetite Depressants; D003503:Cyclobutanes; D010919:Placebos; C058254:sibutramine