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Cited by 113Pharmacology and Obesity TreatmentDiabetes Treatment and ManagementBariatric Surgery and Outcomes

Pharmacotherapy for weight loss in adults with type 2 diabetes mellitus

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Norris, Susan L, Zhang, Xuanping, Avenell, Alison, Gregg, Edward, Schmid, Christopher H, Lau, Joseph·2005·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd004096.pub2PMC PMC6718205
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Abstract

BACKGROUND: Obesity is closely related to type 2 diabetes and long-term weight reduction is an important part of the care delivered to obese persons with diabetes. OBJECTIVES: To assess the efficacy of pharmacotherapy for weight loss in adults with type 2 diabetes. SEARCH STRATEGY: Computerized searches were performed of MEDLINE (January 1966 to May 2004), EMBASE (January 1974 to May 2004, Web of Science (January 1981 to May 2004, and other electronic bibliographic databases, supplemented with hand searches of reference lists and selected journals. SELECTION CRITERIA: Randomized, controlled trials were included where pharmacotherapy was used as the primary strategy for weight loss among adults with type 2 diabetes. Published and unpublished literature in any language and with any study design was included. DATA COLLECTION AND ANALYSIS: Two reviewers abstracted data and the quality of included studies was evaluated by assessing potential attrition, as well as selection and measurement bias, and a Jadad score was obtained. Effects were combined using a random effects model. MAIN RESULTS: A sufficient number of studies were available for a quantitative synthesis for fluoxetine, orlistat, and sibutramine. Twenty two randomized controlled trials were included in the review, with a total of 296 participants for fluoxitine, 2036 for orlistat, and 1047 for sibutramine. Pharmacotherapy produced modest reductions in weight for fluoxetine (5.1 kg (95% confidence interval [CI], 3.3 - 6.9) at 24 to 26 weeks follow up; orlistat 2.0 kg (CI, 1.3 - 2.8) at 12 to 57 weeks follow-up, and sibutramine 5.1 kg (CI, 3.2 - 7.0) at 12 to 52 weeks follow-up. Glycated hemoglobin also modestly and significantly reduced for fluoxetine and orlistat. Gastrointestinal side effects were common with orlistat; tremor, somnolence and sweating with fluoxetine; and palpitations with sibutramine. Some studies, using a variety of study designs, were available on other drugs and a significant decrease in weight was noted in three studies of mazindol, one of phenmetrazine, two of phentermine. No studies were identified that fit inclusion criteria for pseudophedrine, ephedra, sertraline, yohimbine, amphetamine or its derivatives, bupropion, topiramate, benzocaine, threachlorocitric acid, sertraline, and bromocriptine. AUTHORS' CONCLUSIONS: Fluoxetine, orlistat, and sibutramine can achieve statistically significant weight loss over 12 to 57 weeks. The magnitude of weight loss is modest, however, and the long-term health benefits remain unclear. The safety of sibutramine is uncertain. There is a paucity of data on other drugs for weight loss or control in persons with type 2 diabetes.

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  • Most reviews on adult antiobesity medications from high profile groups are out of date and do not reflect the available evidence on the most recent antiobesity medication options.

    “Most reviews on adult antiobesity medications from high profile groups are also out of date, and do not reflect the available evidence on the most recent antiobesity medication options.179 -182”

    From Effectiveness and safety of drugs for obesity (2024) · cites this paper as [180]

    The Discussion (page unavailable) identifies this as a review of weight-loss drugs in adults with type 2 diabetes, chiefly fluoxetine, orlistat and sibutramine. It can serve as an example of an older review, but our copy does not establish that most reviews from high-profile groups are out of date or assess whether they reflect evidence on the most recent medication options. (LLM, conf=0.78)

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Research works printed but not linked: 4

  1. [3]3. Conte 1973 {published data only} Conte A. Evaluation of Sanorex-a new appetitie suppressant. Journal of Obese Bariatric Medicine 1973;2:104-7.
  2. [15]15. Faria 2001 {published data only} Faria AN. Sibutramine reduces glucose intolerance in centrally obese hypertensive patients. International Journal of Obesity 2001;25(Suppl 2):S115.
  3. [92]92. Fasting blood sugar (mml/L) Delta I (SE): -2.2 (0.5) Delta C (SE): -0.5 (0.4) (Continued) Pharmacotherapy for weight loss in adults with type 2 diabetes mellitus (Review) Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Cochrane Database of Systematic Reviews Follow-up inter- val: 8 weeks Delta (I-C) (SE): -1.4 (0.6) 2
  4. [166]166. LDL cholesterol (mmol/L) 1. SBP Delta I (SE): -2.1 (0.8) (Continued) Pharmacotherapy for weight loss in adults with type 2 diabetes mellitus (Review) Copyright © 2010 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Delta I (SE): -4.6 (0.3) Delta C (SE): -1.7 (0.2) Delta (I-C) (SE): -2.9 (0.4)

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Authors
Norris, S. L., Zhang, X., Avenell, A., Gregg, E., Schmid, C. H., & Lau, J.
Affiliations
  • Oregon Health & Science University (US)
  • Centers for Disease Control and Prevention (US)
  • University of Aberdeen (GB)
  • Tufts Medical Center (US)
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2005-01-24
Issue
1
Pages
CD004096-CD004096
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd004096.pub2
PMC
PMC6718205
OpenAlex
W2018607604
Cited by
113
References
197
Citations by year
2024: 1 · 2023: 6 · 2022: 4 · 2021: 1 · 2020: 3 · 2019: 3 · 2018: 2 · 2017: 2 · 2016: 2 · 2015: 7 · 2014: 8 · 2013: 10 · 2012: 6
FWCI
1.04
Type
journal article
Language
en
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
Keywords
type 2 diabetes, obesity, weight loss, pharmacotherapy, fluoxetine, orlistat, sibutramine, mazindol, phenmetrazine, phentermine, Ephedra, HbA1c, adverse drug reactions, drug efficacy, anti-obesity drugs, antipsychotic drugs, appetite suppressants
MeSH terms
Orlistat, Adult, Appetite Depressants, Cyclobutanes, Diabetes Mellitus, Type 2, Fluoxetine, Humans, Lactones, Obesity, Weight Loss, Randomized Controlled Trials as Topic, Anti-Obesity Agents

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