Orlistat

Obesity is a risk factor for cardiovascular disease. Orlistat is a gastric and pancreatic lipase inhibitor indicated for the management of obesity. It is the first antiobesity agent that is not a centrally acting appetite suppressant; instead, it decreases absorption of dietary fat in the gastrointestinal tract. The effects of orlistat on weight loss, weight regain, and on a number of obesity-related risk factors have been assessed in large clinical trials of 1 to 2 years' duration. Compared with subjects who received placebo and a hypocaloric diet alone, weight loss of at least 5 to 10% of initial body weight was observed in a significantly larger number of subjects who were treated with orlistat plus a hypocaloric diet during the first year of treatment. Subjects who received orlistat 120 mg three times daily regained significantly less weight than subjects who received placebo during the second year of treatment. In addition, orlistat was found to have favorable effects on blood pressure and concentrations of serum lipid, glucose, and insulin. Gastrointestinal events are the most common adverse effects experienced by patients who received orlistat; however, most of these events were mild to moderate in intensity, transient in duration, and decreased considerably during the second year of treatment.