USING MODERN WEIGHT-LOSS DRUGS: SIBUTRAMINE AND ORLISTAT
Studies with sibutramine and orlistat in a clinical setting have been designed to show what happens in 'real life'. Results from both are favourable, and indeed broadly comparable. On average, one can expect weight loss of around 9% maintained over 12 months, among those who respond to, and continue treatment. However, while every physician involved in weight management will be able to tell you of the marvelously successful patient who lost 40% body weight, they will equally be able to tell you of their abject failures.
When used in conjunction with a low-calorie diet, data show that 77% of sibutramine-administered patients achieve a medically beneficial weight loss of at least 5%. Importantly, continuation of therapy can sustain these weight losses for at least 2 years. Further, a recent meta-analysis has shown that, in sibutramine-administered obese patients, subjects who achieved weight losses of over 4 kg in the first 3 months of treatment were more likely to achieve long-term weight loss maintenance if therapy was continued. This in turn, led to marked improvements in metabolic factors such as lipid profile, insulin sensitivity and hypertension.
A placebo-controlled study involving obese patients found that orlistat can promote and maintain weight loss (when administered in conjunction with a hypocaloric and a eucaloric diet, respectively). During the weight-loss phase (year 1), orlistat patients lost 10.2% body weight, compared with 6.1% in the placebo group. Results from the weight-maintenance phase of the trial (year 2) showed that patients who continued on orlistat regained half as much weight as patients switched to placebo. Weight-loss-associated improvements in cardiovascular risk factors, including lipid profile, blood pressure and fasting glucose, have also been demonstrated.