Effect of orlistat treatment on body composition and resting energy expenditure during a two-year weight-reduction programme in obese Finns.
OBJECTIVE
To examine the effect of orlistat (Xenical) treatment on body composition and resting energy expenditure (REE) during a 2 y weight-reduction programme in obese Finns.


METHODS
Of initially 96 obese subjects who participated in the weight-reduction programme, those 72 subjects (13 men, 59 women, body mass index (BMI) 35.9 +/- 3.9 kg/m2, age 43.4 +/- 6.0 y, mean +/- s.d.) with the complete set of data for 2 y were included in the study.


METHODS
After a 4-week lead-in period, subjects were randomized with either orlistat 120 mg t.i.d. or placebo t.i.d. in conjunction with a mildly hypoenergetic balanced diet for 1 y. This was followed by 1 y double-blind period with the subjects within each treatment group re-assigned to receive orlistat 120 mg t.i.d. or placebo t.i.d. in conjunction with a weight maintenance diet.


METHODS
Body composition and REE were measured after an overnight fast by a bioelectrical impedance method and indirect calorimeter, respectively. The measurements were performed at the beginning and at 3, 6, 12 and 24 months.


RESULTS
During the first year, the orlistat-treated group had greater reduction of body weight and fat mass but not of fat-free mass or REE as compared to placebo. During the second year, orlistat treatment was associated with smaller regain of body weight and fat mass with no significant differences in the changes of fat-free mass or REE as compared to placebo.


CONCLUSIONS
In addition to better weight loss and maintenance of reduced weight, orlistat treatment is associated with beneficial changes in body composition but with no excess decrease in resting energy expenditure as compared to that achieved during placebo with a dietary therapy alone.
Karhunen
L
L
Department of Clinical Nutrition, University of Kuopio, Kuopio University Hospital, Finland. Leila.Karhunen@uku.fi
Franssila-Kallunki
A
A
Rissanen
P
P
Valve
R
R
Kolehmainen
M
M
Rissanen
A
A
Uusitupa
M
M
D000328:Adult; D019440:Anti-Obesity Agents / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D001823:Body Composition / Q000187:drug effects*; D001824:Body Constitution; D015992:Body Mass Index; D002153:Calorimetry, Indirect; D004311:Double-Blind Method; D017097:Electric Impedance; D004734:Energy Metabolism / Q000187:drug effects*; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D005387:Finland; D006801:Humans; D007783:Lactones / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D008049:Lipase / Q000037:antagonists & inhibitors; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy / Q000628:therapy*; D000077403:Orlistat; D010919:Placebos; D015431:Weight Loss
D019440:Anti-Obesity Agents; D004791:Enzyme Inhibitors; D007783:Lactones; D010919:Placebos; D000077403:Orlistat; D008049:Lipase