Abstract
OBJECTIVE: To examine the effect of orlistat (Xenical™) treatment on body composition and resting energy expenditure (REE) during a 2 y weight-reduction programme in obese Finns.
SUBJECTS: Of initially 96 obese subjects who participated in the weight-reduction programme, those 72 subjects (13 men, 59 women, body mass index (BMI) 35.9±3.9 kg/m2, age 43.4±6.0 y, mean±s.d.) with the complete set of data for 2 y were included in the study.
DESIGN: After a 4-week lead-in period, subjects were randomized with either orlistat 120 mg t.i.d. or placebo t.i.d. in conjunction with a mildly hypoenergetic balanced diet for 1 y. This was followed by 1 y double-blind period with the subjects within each treatment group re-assigned to receive orlistat 120 mg t.i.d. or placebo t.i.d. in conjunction with a weight maintenance diet.
MEASUREMENTS: Body composition and REE were measured after an overnight fast by a bioelectrical impedance method and indirect calorimeter, respectively. The measurements were performed at the beginning and at 3, 6, 12 and 24 months.
RESULTS: During the first year, the orlistat-treated group had greater reduction of body weight and fat mass but not of fat-free mass or REE as compared to placebo. During the second year, orlistat treatment was associated with smaller regain of body weight and fat mass with no significant differences in the changes of fat-free mass or REE as compared to placebo.
CONCLUSION: In addition to better weight loss and maintenance of reduced weight, orlistat treatment is associated with beneficial changes in body composition but with no excess decrease in resting energy expenditure as compared to that achieved during placebo with a dietary therapy alone.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Weinsier RL, Bracco D, Schutz Y . Predicted effects of small decreases in energy expenditure on weight gain in adult women Int J Obes Relat Metab Disord 1993 17: 693–700.
Ravussin E, Lillioja S, Knowler WC, Cristin L, Freymond D, Abbott WGH, Boyce V, Howard BV, Bogardus C . Reduced rate of energy expenditure as a risk factor for body-weight gain New Engl J Med 1988 318: 467–472.
Saltzman E, Roberts SB . The role of energy expenditure in energy regulation: findings from a decade of research Nutr Rev 1995 53: 209–220.
Ravussin E, Swinburn BA . Metabolic predictors of obesity: cross-sectional versus longitudinal data Int J Obes Relat Metab Disord 1993 17 (Suppl 3): S28–S31.
Cunningham JJ . Body composition as a determinant of energy expenditure: a synthetic review and a proposed general prediction equation Am J Clin Nutr 1991 54: 963–969.
Karhunen L, Franssila-Kallunki A, Rissanen A, Kervinen K, Kesäniemi YA, Uusitupa M . Determinants of resting energy expenditure in obese non-diabetic caucasian women Int J Obes Relat Metab Disord 1997 21: 197–202.
Nelson KM, Weinsier RL, Long CL, Schutz Y . Prediction of resting energy expenditure from fat-free mass and fat mass Am J Clin Nutr 1992 56: 848–856.
Leibel RL, Rosenbaum M, Hirsch J . Changes in energy expenditure resulting from altered body weight New Engl J Med 1995 332: 621–628.
Guerciolini R . Mode of action of orlistat Int J Obes Relat Metab Disord 1997 21 (Suppl 3): S12–S23.
Uusitupa M . New aspects in the management of obesity: operation and the impact of lipase inhibitors Curr Opin Lipidol 1999 10: 3–7.
Sjöström L, Rissanen A, Andersen T, Boldrin M, Golay A, Koppeschaar HP, Krempf M . Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients. European Multicentre Orlistat Study Group Lancet 1998 352: 167–172.
Ferrannini E . The theoretical bases of indirect calorimetry: a review Metabolism 1988 37: 287–301.
Ravussin E, Bogardus C . Relationship of genetics, age, and physical fitness to daily energy expenditure and fuel utilization Am J Clin Nutr 1989 49: 968–975.
James WPT, Schofield EC . Human Energy Requirements: A Manual for Planners and Nutritionalists Published by arrangement with the Food and Agriculture Organization of the United Nations. Oxford University Press: Oxford 1990.
Drent ML, Larsson I, William-Olsson T, Quaade F, Cxubayko F, von Bergmann K, Stobel W, Sjöström L, van der Veen EA . Orlistat (Ro 18-0647), a lipase inhibitor, in the treatment of human obesity: a multiple dose study Int J Obes Relat Metab Disord 1995 19: 221–226.
James WP, Avenell A, Broom J, Whitehead J . A one-year trial to assess the value of orlistat in the management of obesity Int J Obes Relat Metab Disord 1997 21 (Suppl 3): S24–S30.
Davidson MH, Hauptman J, DiGirolamo M, Foreyt JP, Halsted CH, Heber D, Heimburger DC, Lucas CP, Robbins DC, Chung J, Heymsfield SB . Weight control and risk factor reduction in obese subjects treated for 2 y with orlistat: a randomized controlled trial JAMA 1999 281: 235–242.
Drent ML, Popp-Snijders C, Ader HJ, Jansen JB, van der Veen EA . Lipase inhibition and hormonal status, body composition and gastrointestinal processing of a liquid high-fat mixed meal in moderately obese subjects Obes Res 1995 3: 573–581.
Forster JL, Jeffery RW, Snell MK . One-year follow-up study to a worksite weight control program Prev Med 1988 17: 129–133.
Kramer FM, Jeffery RW, Forster JL, Snell MK . Long-term follow-up of behavioral treatment for obesity: patterns of weight regain among men and women Int J Obes 1989 13: 123–136.
Hill JO, Hauptman J, Anderson JW, Fujioka K, O'NeilPM, Smith DK, Zavoral JH, Aronne LJ . Orlistat a lipase inhibitor, for weight maintenance after conventional dieting: a 1-y study Am J Clin Nutr 1999 69: 1108–1116.
Ravussin E, Burnand B, Schutz Y, Jequier E . Energy expenditure before and during energy restriction in obese patients Am J Clin Nutr 1985 41: 753–759.
Kinney JM . Influence of altered body weight on energy expenditure Nutr Rev 1995 53: 265–268.
Van Gaal LF, Vansant GA, De Leeuw IH . Factors determining energy expenditure during very-low-calorie diets Am J Clin Nutr 1992 56: 224S–229S.
Deurenberg P . Limitations of the bioelectrical impedance method for the assessment of body fat in severe obesity Am J Clin Nutr 1996 64 (Suppl): 449S–452S.
Kushner RF, Kunigk A, Alspaugh M, Andronis PT, Leitch CA, Schoeller DA . Validation of bioelectrical-impedance analysis as a measurement of change in body composition in obesity Am J Clin Nutr 1990 52: 219–223.
Utter AC, Nieman DC, Ward AN, Butterworth DE . Use of the leg-to-leg bioelectrical impedance method in assessing body-composition change in obese women Am J Clin Nutr 1999 69: 603–607.
Acknowledgements
The authors wish to thank Ms Erja Kinnunen, Ms Marita Lauronen, Ms Irja Lyytikäinen, Ms Auli Paananen, Ms Sirpa Sarlio-Lähteenkorva and Ms Helena Åkerfelt for expert help in this study. The study was supported by a grant from F Hoffman-La Roche Ltd to the Universities of Kuopio and Helsinki, and by grants from the Kuopio University Hospital, and the Academy of Finland, Research Council for Health.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Karhunen, L., Franssila-Kallunki, A., Rissanen, P. et al. Effect of orlistat treatment on body composition and resting energy expenditure during a two-year weight-reduction programme in obese Finns. Int J Obes 24, 1567–1572 (2000). https://doi.org/10.1038/sj.ijo.0801443
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.ijo.0801443
Keywords
This article is cited by
-
Pharmacological modulation of adaptive thermogenesis: new clues for obesity management?
Journal of Endocrinological Investigation (2023)
-
Benefit-Risk Assessment of Orlistat in the Treatment of Obesity
Drug Safety (2014)
-
Orlistat 60 mg Reduces Visceral Adipose Tissue: A 24‐Week Randomized, Placebo‐Controlled, Multicenter Trial
Obesity (2011)
-
Long-term effects of lipase inhibition by orlistat on gastric emptying and orocecal transit time of a solid meal
Journal of Gastroenterology (2008)
-
Economic Evaluation of Weight Loss Interventions in Overweight and Obese Women
Obesity (2006)