Orlistat use outside of clinical trials: The Irish experience
A Tuthill1, R Kelly2, Y Ryan1 & D O'Shea1
Recent analysis has shown that up to 18 percent of the Irish population are obese; a further 40 percent are overweight. Orlistat (Xenical)is a gastrointestinal lipase inhibitor that limits absorption of ingested fat thus aiding weight reduction. We report the use of orlistat outside the clinical trial setting in Ireland from 7 April 2000 to 30 June 2001.
A total of 5,251 patients (4,376 women, 875 men) attended 240 weight management clinics (229 in primary care and 11 in secondary care) for a first assessment. At the first visit, 6.9 percent (304/4,376) women and 21.9 percent (192/875) men had diabetes. A total of 65 percent of these patients attended for 2 or more visits and 88.9 percent (3,024) started treatment. The mean duration of attendance at these clinics was 133 days in women and 127 days in men. Both men and women achieved a significant weight reduction. The mean weight reduction in women was 5.06 Kilogram (5.05 percent starting body weight) (p less than 0.05) with a corresponding body mass index(BMI) reduction of 1.86 Kilogram meter squared (-1). The mean weight reduction in men was 6.5 Kilogram (5.51 percent starting body weight) (p less than 0.05) with a BMI reduction of 1.83 Kilogram meter squared (-1). Patients with diabetes had a higher weight and BMI at time of starting orlistat but also achieved a significant weight loss. In men with diabetes, the average weight loss was 5.47 Kilogram (4.55 percent starting body weight) (p less than 0.05) and for women 4.92 Kilogram (4.68 percent starting body weight) (p less than 0.05).
This report indicates that orlistat is a useful agent in the management of obesity both in patients with simple obesity and with comorbidities, in primary and secondary care settings outside of clinical trials.