The effect of sibutramine on energy expenditure and body composition in obese adolescents.
BACKGROUND
Childhood obesity is now considered to be an epidemic. Drug therapy in this age group remains a topic of research.


OBJECTIVE
The objective of this study was to examine the effect of treatment with sibutramine (10 mg) on body composition and energy expenditure in obese adolescents.


METHODS
The study was conducted as a randomized, double-blind, placebo-controlled trial.


METHODS
The study was set in an obesity research center.


METHODS
The patients were 24 obese adolescents (age 12-17 yr, 11 boys); four patients withdrew.


METHODS
Intervention was sibutramine (Meridia) or placebo in combination with an energy-restricted diet and exercise plan for 12 wk, followed by an identical, but medication-free, treatment period (follow-up).


METHODS
Change in body mass index (BMI) sd score (BMI-SDS) was the principal measure of efficacy. Body composition and total energy expenditure were measured by stable isotopes and further calculated according to the four-component model, using underwater weighing and dual x-ray absorptiometry. Basal metabolic rate (BMR) was measured by ventilated hood and adjusted for sex and body composition (BMRadj).


RESULTS
After intervention, the decrease in BMI-SDS was comparable in both groups. During follow-up, BMI further decreased in the placebo group but stabilized in the sibutramine group. Changes in the percentage of fat mass were not different between both groups. BMRadj decreased in the placebo group and remained constant in the sibutramine group. During follow-up, BMRadj decreased in the sibutramine group and increased in the placebo group. Changes in total energy expenditure were not significantly different.


CONCLUSIONS
The effect of sibutramine on BMI-SDS was not significant. Sibutramine may diminish the decrease in BMRadj associated with energy restriction in obese adolescents.
Van Mil
Edgar G A H
EG
Department of Methodology and Statistics and Human Biology, Nutrition Environment and Toxicology Research Institute Maastrict, Maastrict University, and Department of Pediatrics, University Hospital Maastrict, The Netherlands. e.vanmil@vumc.nl
Westerterp
Klaas R
KR
Kester
Arnold D M
AD
Delemarre-van de Waal
Henriette A
HA
Gerver
Willem J M
WJ
Saris
Wim H M
WH
D000293:Adolescent; D000365:Age Determination by Skeleton; D001067:Appetite Depressants / Q000627:therapeutic use*; D001794:Blood Pressure; D001823:Body Composition / Q000187:drug effects*; D001827:Body Height / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D003503:Cyclobutanes / Q000627:therapeutic use*; D004311:Double-Blind Method; D004734:Energy Metabolism / Q000187:drug effects*; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D009765:Obesity / Q000188:drug therapy / Q000503:physiopathology*; D010919:Placebos
D001067:Appetite Depressants; D003503:Cyclobutanes; D010919:Placebos; C058254:sibutramine