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Orlistat Does Not Appear to Benefit Patients With Fatty Liver Disease HOBOKEN, NJ -- January 14, 2009 -- Orlistat does not help patients with fatty liver disease (FLD) lose weight, nor does it improve their liver enzymes or insulin resistance, according to a study published in the January issue of Hepatology. Stephen A. Harrison, MD, Brooke Army Medical Center, Houston, Texas, and colleagues conducted a randomised, controlled trial of overweight patients with FLD to determine the effect of orlistat in conjunction with caloric restriction. They included 50 people who had been diagnosed with FLD after clinical evaluation and liver biopsy. For 36 weeks, all subjects followed a diet of 1,400 calories per day, a multivitamin and vitamin E regimen, and were randomised to take orlistat 120 mg orally TID with meals or a placebo. After 36 weeks, patients underwent a liver biopsy and the researchers looked for improvement in fat levels and fibrosis score. They also monitored changes in biochemical data such as fasting insulin and glucose, liver enzymes, lipid panel vitamin E, and free fatty acid levels. "Comparing the orlistat group to the non-orlistat group at study completion, no significant differences were identified between the 2 groups for mean weight loss, serum, insulin resistance or cholesterol," the authors wrote. In addition, there were no significant differences in the liver biopsy findings. Because there were no notable differences between the 2 groups, the researchers reanalysed the data to compare subjects who lost differing amounts of body weight. They noted a linear relationship between weight loss and liver improvement. In fact, body weight loss of 9% or more resulted in the greatest amount of liver improvement. "In conclusion, while this preliminary study does not demonstrate a weight loss advantage with the use of orlistat," the authors said, "it does demonstrate that moderate weight loss is associated with significant improvements in the symptoms of FLD." SOURCE: Wiley-Blackwell E-mail this page to a friend or colleague! To print, use this version