title: Pragmatic study of orlistat 60 mg on abdominal obesity.
abstract: OBJECTIVE
  It is well established that combining a reduced calorie, low-fat diet with the lipase inhibitor orlistat results in significantly greater weight loss than placebo plus diet. This weight loss is accompanied by changes in adipose tissue (AT) distribution. As 60 mg orlistat is now available as an over-the-counter medication, the primary objective of this study was to determine whether 60 mg orlistat is effective as a weight loss option in a free-living community population with minimal professional input.
  
  
  METHODS
  AT and ectopic lipid content were measured using magnetic resonance imaging and (1)H MR spectroscopy, respectively, in 27 subjects following 3 months treatment with orlistat 60 mg and a reduced calorie, low-fat diet.
  
  
  RESULTS
  Significant reductions in intra-abdominal AT (-10.6%, P=0.023), subcutaneous (-11.7% P<0.0001) and pericardial fat (-9.8%, P=0.034) volumes and intrahepatocellular lipids (-43.3%, P=0.0003) were observed. These changes in body fat content and distribution were accompanied by improvements in plasma lipids and decreases in blood pressure and heart rate.
  
  
  CONCLUSIONS
  These findings suggest that over-the-counter 60 mg orlistat, in combination with the type of advice a subject could expect to be given when obtaining 60 mg orlistat in a community setting, does indeed result in potentially clinically beneficial changes in body composition and risk factors for metabolic diseases.
authors.affiliation: Metabolic and Molecular Imaging Group, MRC Clinical Sciences Centre, Imperial College London, Hammersmith Hospital, London, UK. louise.thomas@csc.mrc.ac.uk
authors.forename: E L
authors.initials: EL
authors.lastname: Thomas
authors.forename: A
authors.initials: A
authors.lastname: Makwana
authors.forename: R
authors.initials: R
authors.lastname: Newbould
authors.forename: A W
authors.initials: AW
authors.lastname: Rao
authors.forename: G
authors.initials: G
authors.lastname: Gambarota
authors.forename: G
authors.initials: G
authors.lastname: Frost
authors.forename: B
authors.initials: B
authors.lastname: Delafont
authors.forename: R G
authors.initials: RG
authors.lastname: Mishra
authors.forename: P M
authors.initials: PM
authors.lastname: Matthews
authors.forename: E S
authors.initials: ES
authors.lastname: Berk
authors.forename: S M
authors.initials: SM
authors.lastname: Schwartz
authors.forename: J D
authors.initials: JD
authors.lastname: Bell
authors.forename: J D
authors.initials: JD
authors.lastname: Beaver
mesh_terms: D050153:Abdominal Fat / Q000187:drug effects / Q000473:pathology; D050154:Adiposity / Q000187:drug effects; D000328:Adult; D019440:Anti-Obesity Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015992:Body Mass Index; D003131:Combined Modality Therapy; D018752:Diet, Fat-Restricted; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007783:Lactones / Q000008:administration & dosage / Q000627:therapeutic use*; D008049:Lipase / Q000037:antagonists & inhibitors*; D050356:Lipid Metabolism / Q000187:drug effects; D008055:Lipids / Q000097:blood; D008099:Liver / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000008:administration & dosage / Q000627:therapeutic use*; D056128:Obesity, Abdominal / Q000097:blood / Q000178:diet therapy / Q000188:drug therapy* / Q000473:pathology; D000077403:Orlistat; D050177:Overweight / Q000097:blood / Q000178:diet therapy / Q000188:drug therapy / Q000473:pathology; D015431:Weight Loss / Q000187:drug effects; D055815:Young Adult
chemical_list: D019440:Anti-Obesity Agents; D004791:Enzyme Inhibitors; D007783:Lactones; D008055:Lipids; D004366:Nonprescription Drugs; D000077403:Orlistat; D008049:Lipase