The effect of orlistat on body weight and coronary heart disease risk profile in obese patients: The Swedish Multimorbidity Study

Authors


  • *H. Hildefors, VC Eden Malmö; A. Kohlström, Lundens Läkargrupp Malmö; U.-B. Eriksson, Läkargruppen Gustaf Adolf Malmö; S. Jönsson and J. Kosjerina, Linnero VC Lund; R. Ekesbo, VC Dalby; U. Pettersson, Ekaryd Söderåkra; E. Gardell, Hemse VC; P. Revesz, Husläkarmottagning Göteborg; K. Ekenbratt, Partille Privatvård; J. Månsson, Husläkarna Kungsbacka; L. Siltala, Stortorgets Läkarmottagning Nässjö; A. Norring, Läkartjänst Ljusdal; M. Falkenberg, Kisa VC; B. Höglund, Åsö VC Stockholm; C. Elofsson, VC Östertull Norrköping; J. Holm, Läkarcentrum Katrineholm; C. Wirgin, Handens VC Stockholm; D. Befrits, Johanneshovshälsan Stockholm; S. Norberg, Hornstulls VC Stockholm; I. Egardt, VC Bergshamra Solna; P. Lidström, Lundakliniken Spånga; M. Öhrvall, Samariterhemmet Uppsala; E. Löwenhoff, Närvården Linnean Uppsala; M. Larsson, Sätra Hälsocentral Gävle; T. Aronen, Familjeläkarna Heby; D. Ottosson, Sala Norra VC; G. Holmberg, Läkarmottagning Ankaret Karlstad; A. Egilsson, VC Verkstaden Arvika; R. Borelius, Kvartersakuten Leksand; G. Wåström, Timrå VC; M. Frisk, Läkarmottagning Stockholm; E. Bergh, Kramfors VC.

: Folke Lindgärde, Department of Vascular Disease, Malmö University Hospital, University of Lund, 20502 Malmö, Sweden (fax: + 46 40 19 46 17; e-mail: folke.lindgarde@medforsk.mas.lu.se).

Abstract

Abstract. Lindgärde F (Department of Vascular Disease, Malmö University Hospital, University of Lund, Malmö, Sweden). The effect of orlistat on body weight and coronary heart disease risk profile in obese patients: The Swedish Multimorbidity Study. J Intern Med 2000; 248: 245–254.

Objective. To assess the effect of orlistat on body weight and cardiovascular risk amongst obese patients at high coronary risk.

Design. After screening, patients entered a two-week single-blind placebo lead-in period, during which they followed a mildly hypocaloric diet, before being randomized to double-blind treatment with either orlistat 120 mg or placebo three times daily, in conjunction with dietary intervention for 1 years.

Setting. The study was conducted at 33 primary care centres in Sweden.

Subjects. A total of 382 obese adults (body mass index 28–38 kg m–2) with type 2 diabetes, hypercholesterolaemia and/or hypertension were recruited, of whom 376 were randomized to orlistat (n = 190) or placebo (n = 186).

Main outcome measures. Change in body weight, waist and hip circumferences, blood pressure, serum lipid profile, fasting glucose and HbA1c.

Results. After 1 years, mean weight loss was significantly greater with orlistat compared with placebo (5.9% vs. 4.6%; P < 0.05). Moreover, significantly more orlistat-treated patients than placebo recipients maintained weight loss of ≥ 5% (54.2% vs. 40.9%; P < 0.001). Orlistat was also associated with significantly greater improvements than placebo in total serum cholesterol (– 3.3% vs. –0.5%; P < 0.05), LDL-cholesterol (– 7.0% vs. –1.1%; P < 0.05), fasting glucose (5.1% vs. –0.1%; P < 0.01) and HbA1c (– 2.7% vs. –0.5%; P < 0.05). Similar results were reported for the subgroup of patients with type 2 diabetes. Orlistat was well tolerated.

Conclusions. Treatment with orlistat in conjunction with diet promotes significantly greater weight loss and cardiovascular risk factor reduction than diet alone amongst obese patients at high risk of future coronary events.

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