Addition of orlistat to conventional treatment in adolescents with severe obesity.
To investigate the efficacy and tolerability of orlistat in obese adolescents, a prospective, open-label, randomised, controlled pilot trial was performed. A total of 22 adolescents with exogeneous obesity were started on orlistat (120 mg tid) and a daily multivitamin preparation in addition to conventional treatment which included nutritional and lifestyle modification programmes. The control group consisted of 20 obese adolescents who had similar duration of follow-up under conventional treatment alone. Of the 22 patients, 7 dropped out within the 1st month of the trial due to side-effects attributable to orlistat. The remaining 15 patients on orlistat were followed for 5-15 months (average duration of treatment 11.7 +/- 3.7 months). The control group was similar in age, sex, and duration of follow-up (10.2 +/- 3.7 months, range 6-17 months) to the orlistat group. Compared to initial body weight, patients in the orlistat group lost -6.27 +/- 5.4 kg, whereas those in the control group gained 4.16 +/- 6.45 kg (P < 0.001) during the study period. Patients in the orlistat group lost -7.65% +/- 6.5% of their initial body weight, whereas, those of the control group gained 5.7% +/- 8.3% (P < 0.001). The body mass index decreased in the orlistat group by -4.09 +/- 2.9 kg/m2 while it increased by + 0.11 +/- 2.49 kg/m2 in the control group (P < 0.001). Mild gastrointestinal complaints (frequent stools) were experienced by all patients in the orlistat group.


CONCLUSIONS
Orlistat could be a useful adjunct in the treatment of severe obesity in adolescents; however, gastrointestinal side-effects limit its usefulness in almost one in three adolescents.
Ozkan
Behzat
B
Division of Paediatric Endocrinology, Department of Paediatrics, Ataturk University, Erzurum, Turkey.
Bereket
Abdullah
A
Turan
Serap
S
Keskin
Sabiha
S
D000293:Adolescent; D019440:Anti-Obesity Agents / Q000627:therapeutic use*; D015992:Body Mass Index; D031204:Caloric Restriction; D002648:Child; D003131:Combined Modality Therapy; D015444:Exercise; D005242:Fecal Incontinence / Q000139:chemically induced; D005260:Female; D006801:Humans; D007783:Lactones / Q000627:therapeutic use*; D008019:Life Style; D008049:Lipase / Q000037:antagonists & inhibitors; D008297:Male; D009765:Obesity / Q000628:therapy*; D000077403:Orlistat; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome; D014815:Vitamins / Q000627:therapeutic use
D019440:Anti-Obesity Agents; D007783:Lactones; D014815:Vitamins; D000077403:Orlistat; D008049:Lipase