Pragmatic study of orlistat 60mg on abdominal obesity

Elizabeth Louise Thomas (1) , Aidan Makwana (1) , Rexford Newbould (1) , Anil Rao (1) , Giulio Gambarota (1) , Gary Frost (1) , Bruno Delafont (1) , Rajesh Mishra (1) , Paul Matthews (1) , Evan Berk (1) , Susan Schwartz (1) , Jimmy Bell (1) , John Beaver (1)

1 Metabolic and Molecular Imaging Group

Background and Aims: It is well established combining a reduced calorie, low fat diet with the lipase inhibitor orlistat, results in significantly greater weight loss than placebo plus diet. This weight loss is accompanied by changes in adipose tissue (AT) distribution. Since 60mg orlistat is now available as an over-the-counter medication, the primary objective of this study was to determine whether 60mg orlistat is as effective a weight loss option in a free living community population with minimal professional input. Methods: Adipose tissue and ectopic lipid content were measured using MRI and 1H MR Spectroscopy (MRS), respectively, in 27 subjects following 3 months treatment with orlistat 60mg and a reduced calorie, low-fat diet. Results: Significant reductions in intra-abdominal AT (-10.6%, p=0.023) subcutaneous (-11.7% p<0.0001) and pericardial fat (-9.8%, p=0.034) volumes and intra-hepatocellular lipids (IHCL) (-43.3%, p=0.0003) were observed. These changes in body fat content and distribution were accompanied by improvements in plasma lipids and decreases in blood pressure and heart rate. Conclusion: These findings suggest that over-the-counter 60 mg orlistat, in combination with the type of advice a subject could expect to be given when obtaining 60 mg orlistat in a community setting does indeed result in potentially clinically beneficial changes in body composition and risk factors for metabolic diseases.

Mots clés: Magnetic Resonance imaging; Intra-hepatocellular lipid; Adipose tissue; weight loss; Orlistat; visceral fat

Elizabeth Louise Thomas, Aidan Makwana, Rexford Newbould, Anil Rao, Giulio Gambarota, et al.. Pragmatic study of orlistat 60mg on abdominal obesity. European Journal of Clinical Nutrition, 2011, ⟨10.1038/ejcn.2011.108⟩. ⟨hal-00654480⟩