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ECO: Orlistat (Xenical) Shown Effective in Obese Patients in Community Practices By Jill Stein Special to DG News VIENNA, AUSTRIA -- June 4, 2001 -- Orlistat (Xenical) therapy effectively promotes weight loss and improves co-morbidities in obese patients treated in community practices, researchers reported here at the 11th European Congress on Obesity (ECO). Until now, orlistat has only been systematically studied in clinical trials. The new results were presented by Dr. Alfred Wirth, with the Teutoburger-Wald-Klinic in Bad Rothenfelde, Germany, and are drawn from an observational trial that was conducted to assess the effect of orlistat on body weight and obesity-related co-morbidities in clinical practice. Orlistat is a non-systemically acting weight management agent that reduces the absorption of dietary fat by 30 percent. In two-year-long placebo-controlled trials in overweight and obese patients, orlistat plus a mildly reduced-calorie diet produced greater weight loss and improved maintenance of reduced weight compared with diet alone. Dr. Wirth's trial included 15,549 obese patients. Overall, 15,201 patients were treated by 5,686 primary health care physicians and 348 patients were treated by 60 hospital physicians. The recommended therapy was orlistat, 120 mg TID. The agent was used in conjunction with a reduced-fat diet in approximately three-fourths of patients and with physical activity in roughly half the patients. About one-third of patients participated in a specific orlistat-based weight management program. The mean duration of obesity prior to orlistat therapy was 14 years. While most patients had previously tried to lose weight, very few had been able to achieve and maintain a weight loss of five percent or more. Approximately half of patients had one to two co-morbidities, while about one-third had three or more co-morbidities. The study found that the mean weight loss with orlistat after a mean of 7.1 months of treatment was 10.7 percent of body weight, or approximately 11 kg (24.2 pounds), Dr. Wirth said. Waist circumference decreased by 7.7 cm in women and 8.5 cm in men. Overall, 87 percent of patients (13,527) lost at least 5 percent of their total body weight, and 50 percent (7,774) lost at least 10 percent. Orlistat treatment was also associated with significant improvements in systolic and diastolic blood pressure, blood glucose, total cholesterol, low-density lipoprotein (LDL)- cholesterol, high-density lipoprotein (HDL)- cholesterol, and triglycerides. The benefit was most pronounced in patients with co-morbidities at the start of therapy. In many cases, co-morbidity medications could be stopped or decreased during orlistat therapy. Orlistat was well tolerated. Adverse events (primarily gastrointestinal) were documented in only 1.5 percent of patients. The efficacy of orlistat was considered good to excellent by 86 percent of physicians, and safety was rated as good to excellent by 92 percent. Dr. Wirth said that the results in this "real-world" population corroborate those observed in clinical trials using orlistat. Related Link: Orlistat (Xenical). E-mail this page to a friend or colleague! To print, use this version