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Orlistat treatment in obese prepubertal children: a pilot study
S Norgren1, P Danielsson, R Jurold
1National Childhood Obesity Center and Pediatric Endocrine Research Unit, Department of Pediatrics, Karolinska Institutet and Huddinge University Hospital, Stockholm, Sweden. svante.norgren@klinvet.ki.se
Aim:
This study investigated orlistat treatment in obese prepubertal children with regard to tolerance, safety and psychological well-being.
Methods:
11 healthy, severely obese prepubertal children (age 8.3-12.3 y, body mass index standard deviation score 5.3-9.2) were recruited for a 12 wk open treatment. Before, during and after treatment, the participants were investigated by psychological evaluation, blood chemistry, and parameters reflecting obesity and fat mass.
Results:
The participants were able to comply with the treatment, as indicated by pill counts and self reports, and expressed a desire to continue the treatment after the study period. Gastrointestinal side effects were mild and tolerable. No negative effects on psychological or physical well-being were detected, and the psychological evaluation demonstrated increased avoidance of fattening food, body shape preoccupation and oral control (p = 0.011). The median weight loss was 4.0 kg (range -12.7 to +2.5 kg, p = 0.016) and was highly correlated to decreased fat mass (regression coefficient 0.953, p < 0.01).
Conclusion:
This pilot study indicates that obese prepubertal children were able to reduce their fat intake to avoid gastrointestinal side effects. Thus, orlistat may be suitable as a component in behaviour-modification programmes for obese children, and the results prompt a placebo-controlled investigation of its effectiveness in promoting weight loss.