BOSTON — Three years of orlistat following significant weight loss helped patients maintain the loss and reduced the incidence of new-onset type 2 diabetes, Dr. Bjorn Richelsen said at the annual meeting of NAASO, the Obesity Society.
“We know that we can induce initial weight loss, with maximal loss occurring after about 6–9 months, but thereafter, a strong regain occurs, so we need strategies for weight loss maintenance,” Dr. Richelsen said.
In a study that included 383 abdominally obese patients from Denmark, Norway, Sweden, and Finland, 309 were able to lose at least 5% of their body weight during a 2-month very low energy diet consisting of 600–800 kcal/day and were randomized to 3 years of lifestyle counseling plus orlistat, 120 mg three times daily, or placebo.
Mean body mass index at baseline was 37.5 kg/m
There was an initial mean weight loss of 14.4 kg in the patients who subsequently were randomized. During each of the 3 years of the study, a statistically significantly greater number of patients in the orlistat group maintained at least a 5% weight loss, compared with those in the placebo group.
Patients in the orlistat group regained a mean of 4.6 kg during the 3 years, whereas those in the placebo group regained a mean of 7 kg. The overall weight loss, therefore, was 8.3% of body weight in the orlistat group and 6.4% in the placebo group, said Dr. Richelsen of the department of endocrinology and metabolism, Århus University Hospital, Århus, Denmark.
Waist circumference also was significantly more reduced in the orlistat group, by 7.7 cm, than in the placebo group, by 5.4 cm.
In contrast to findings from other studies, there were no differences between the active treatment group and the placebo group after 3 years on risk factors including insulin, glucose, and lipids. Nonetheless, there was a significantly lower incidence of new-onset diabetes during the study, with 8 cases (5.2%) developing in the orlistat-treated patients, compared with 17 cases (10.9%) in the placebo-treated patients.