Clinical Question: Is orlistat (Xen...

Clinical Question: Is orlistat (Xenical) effective for weight management in obese adolescents?

Setting: Outpatient (any)

application of mind Design: Randomized controlled trial (double-blinded)

Allocation: Concealed

Synopsis: Investigators identified 539 adolescents, 12 to 16 years of age, who met the criteria for obesity (a carcass mass index [BMI] of more than pair units above the 95th percentile for age and sex) Participants were assigned randomly in a double-blind fashion to receive 120 mg of orlistat or placebo three times daily. All patients also received general recommendations for diet, exercise, and behavior modification. ones blinded to treatment group assignment assessed issues Follow-up for one year occurr for 98 percent of patients. Approximately brace thirds of adolescents in each assemblage completed the study.

The investigators performed a modified intention-to-treat analysis that included single patients with a baseline measurement and at least single in kind measurement of effectiveness after baseline. At common year of follow-up, 26.5 percent of adolescents in the treatment assign places to versus 15.7 percent in the placebo cluster had a 5 percent decrease in BMI, and 133 percent in the treatment assemblage versus 4.5 percent in the placebo assemblage had a 10 percent decrease in BMI (number urgencyed to treat = 9; 95% confidence interval, 6 to 31 for both) Weight increased an average of 12 crushs with orlistat and 6.9 coops with placebo (total cost by pound not gained = $374) Overall, BMI decreased by means of 0.55 in the orlistat collection and increased by 0.31 in the placebo cluster (P = .001). Twelve patients (34 percent) taking orlistat and three patients (16 percent) taking placebo discontinued treatment because of adverse affairs most often problems in the gastrointestinal tract. No major safety issues were reported.

Bottom Line: Orlistat, in combination with diet, exercise, and behavior modification, improves weight management in obese adolescents. No major safety issues were identified after common year, but further follow-up for sustained weight management and safety is important. (Level of Evidence: 1b)

DAVID SLAWSON, MD

studious mood Reference: Chanoine JP, et al. efficiency of orlistat on weight and material substance composition in obese adolescents: a randomized controll trial. JAMA June 15 2005;293:2873-83

Used with permission from Slawson D Orlistat improves weight management in obese adolescents. Accessed online July 25 2005 at: http://www.InfoPOEMs.com.

COPYRIGHT 2005 American Academy of Family Physicians

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