Orlistat: new preparation. No hurry . . .
(1) Treatments for obesity are disappointing.  None has yet shown an effect on morbidity and mortality.  Non drug treatments are poorly assessed.  Stable long-term weight loss necessitates long-term management.  (2) Orlistat, a gastrointestinal lipase inhibitor, is indicated, in combination with a low-calorie diet, for the management of obesity.  (3) The assessment file is rather bulky and methodologically sound, at least in terms of the "weight loss" end point.  (4) During medium-term trials (12-24 months), orlistat administered at a dose of 120 mg three times a day and combined with dietary intervention had a moderate positive impact on body weight (-3.5 kg on average). (5) No longer-term trials have been done.  (6) It is not known whether this drug affects morbidity and mortality linked to obesity.  (7) In clinical trials there was an increase in the frequency of breast cancer among patients treated with orlistat.  This potential risk is currently being assessed in a specific trial.  (8) Gastrointestinal adverse effects are frequent.  (9) Treatment is costly.
D019440:Anti-Obesity Agents; D001943:Breast Neoplasms / Q000139:chemically induced; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D007783:Lactones / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D008049:Lipase / Q000037:antagonists & inhibitors; D009765:Obesity / Q000178:diet therapy / Q000188:drug therapy / Q000191:economics; D016896:Treatment Outcome; D015431:Weight Loss / Q000187:drug effects
D019440:Anti-Obesity Agents; D007783:Lactones; D008049:Lipase