Orlistat treatment in obese prepubertal children: a pilot study.
OBJECTIVE
This study investigated orlistat treatment in obese prepubertal children with regard to tolerance, safety and psychological well-being.


METHODS
11 healthy, severely obese prepubertal children (age 8.3-12.3 y, body mass index standard deviation score 5.3-9.2) were recruited for a 12 wk open treatment. Before, during and after treatment, the participants were investigated by psychological evaluation, blood chemistry, and parameters reflecting obesity and fat mass.


RESULTS
The participants were able to comply with the treatment, as indicated by pill counts and self reports, and expressed a desire to continue the treatment after the study period. Gastrointestinal side effects were mild and tolerable. No negative effects on psychological or physical well-being were detected, and the psychological evaluation demonstrated increased avoidance of fattening food, body shape preoccupation and oral control (p = 0.011). The median weight loss was 4.0 kg (range -12.7 to +2.5 kg, p = 0.016) and was highly correlated to decreased fat mass (regression coefficient 0.953, p < 0.01).


CONCLUSIONS
This pilot study indicates that obese prepubertal children were able to reduce their fat intake to avoid gastrointestinal side effects. Thus, orlistat may be suitable as a component in behaviour-modification programmes for obese children, and the results prompt a placebo-controlled investigation of its effectiveness in promoting weight loss.
Norgren
S
S
National Childhood Obesity Center and Pediatric Endocrine Research Unit, Department of Pediatrics, Karolinska Institutet and Huddinge University Hospital, Stockholm, Sweden. svante.norgren@klinvet.ki.se
Danielsson
P
P
Jurold
R
R
Lötborn
M
M
Marcus
C
C
D015502:Absorptiometry, Photon; D000886:Anthropometry; D019440:Anti-Obesity Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002648:Child; D005260:Female; D006062:Gonadotropins / Q000097:blood; D006801:Humans; D007783:Lactones / Q000494:pharmacology / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood; D008099:Liver / Q000187:drug effects / Q000201:enzymology; D008297:Male; D009765:Obesity / Q000188:drug therapy* / Q000523:psychology; D000077403:Orlistat; D010349:Patient Compliance; D010865:Pilot Projects
D019440:Anti-Obesity Agents; D006062:Gonadotropins; D007783:Lactones; D008055:Lipids; D000077403:Orlistat