Mixed
Orlistat combined with behavioral intervention results in greater weight loss (average 3.0 kg or 6.6 lb more) than placebo plus behavioral intervention at 12 months, though with higher rates of gastrointestinal adverse effects leading to withdrawal.
Orlistat (120 mg, 3x/day) combined with behavioral counseling helps you lose about 3 kg (6.6 lbs) more than placebo over 12 months. However, be aware that gastrointestinal side effects are common and lead to higher dropout rates. Serious side effects are not increased, but the modest benefit may not be worth the side effects for everyone.
In the 12 trials that could be combined by meta-analysis, participants randomly assigned to orlistat lost 3.0 kg (6.6 lb) more (95% CI, -3.9 to -2.0 kg) than those receiving placebo after 12 months... Participants randomly assigned to receive orlistat were more likely to experience adverse effects and withdraw from trials because of adverse effects than those assigned to placebo.
Why this rating
Based on 12 trials, but limited by high attrition, lack of post-discontinuation data, and only one good-quality trial.
Source
Effectiveness of Primary Care–Relevant Treatments for Obesity in Adults: A Systematic Evidence Review for the U.S. Preventive Services Task Force
Erin S. LeBlanc et al. · Annals of Internal Medicine · 2011
DOI 10.7326/0003-4819-155-7-201110040-00006
More from this paper
- Behaviorally based weight-loss interventions result in statistically significant weight loss (average 3.0 kg or 6.6 lb greater than control) at 12 to 18 months, with greater intervention intensity (12-26 sessions) yielding greater loss (4-7 kg).Good
- Behavioral interventions, orlistat, and metformin all reduce diabetes incidence in patients with prediabetes or elevated risk, with behavioral interventions cutting incidence by about 50% or more over 2-3 years.Good
Related findings · Mixed
- Bariatric surgery (VSG and RYGB) is the most effective and sustainable treatment for obesity, producing marked and sustained weight loss that non-surgical interventions cannot match.Strong
- Severely protein-deficient diets (2–3% energy) induce lean body mass loss and metabolic imbalance, whereas adequate protein intake (0.66 g/kg/d minimum) is a prerequisite for maintaining muscle, bone, and physiological function.Strong
- For patients with Class III obesity (BMI >39.9 kg/m2), metabolic bariatric surgery (MBS) is significantly more effective than any currently approved medication, with BilioPancreatic Diversion (BPD) showing the highest estimated weight loss.Strong
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