Effectiveness and tolerability of orlistat and liraglutide in patients with obesity in a real‐world setting: The XENSOR Study
Open accessAbstract
AIMS: To evaluate in a real-world setting the effectiveness of two drugs, orlistat and liraglutide, in patients with overweight or obesity and insufficient weight loss (WL) after a lifestyle modification programme. METHODS: with at least a weight-related comorbidity who had failed to lose at least 5% of their weight after 6 months of lifestyle modification. The co-primary end-points, assessed at 3-6 months and at the end of the follow-up, were weight change from baseline, proportion of patients who lost at least 5% of their baseline weight and adjusted differences in WL between both drugs. RESULTS: Five hundred patients, 400 in the group of orlistat (age 47.0, weight 107.8 kg) and 100 in the group of liraglutide (age 51.9 years, weight 105.1 kg), were included. Treatment with both drugs significantly reduced weight, fasting plasma glucose, systolic BP, low-density lipoprotein-cholesterol and alanine transaminase over a median follow-up period of 7 months. WL with liraglutide (-7.7 kg) was significantly greater than that observed with orlistat (-3.3 kg), and more individuals lost at least 5% of their baseline weight with liraglutide (64.7%) than with orlistat (27.4%). Rates of prediabetes significantly decreased with liraglutide in comparison to orlistat. CONCLUSIONS: In this real-world study, liraglutide showed a greater effectiveness in WL compared with orlistat and improved several obesity-associated metabolic and cardiovascular risk factors.
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An open-label trial showed that combining liraglutide with orlistat had greater efficacy than orlistat alone, though gains over liraglutide monotherapy were marginal.
“An open-label trial showed greater efficacy than orlistat alone, though gains over liraglutide monotherapy were marginal [188].”
From Precision obesity medicine: A phenotype-guided framework for pharmacologic therapy across the lifespan (2025) · cites this paper as [188]
The Methods and Results describe a retrospective observational study with separate orlistat and liraglutide groups, not an open-label trial of the two drugs combined. The Discussion (page unavailable) reports greater weight loss with liraglutide alone than with orlistat; it provides no comparison between combination treatment and liraglutide monotherapy. (LLM, conf=0.88)
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Experimental — accuracy not yet measuredThe majority of real-world studies conducted in patients initiating incretin-based anti-obesity medications were retrospective and included liraglutide users, while only a few studies investigated semaglutide titrated up to 2.4 mg.
“The majority of RWS conducted in patients initiating incretin-based AOM were retrospective51–71 and included liraglutide users, while only a few studies investigated semaglutide titrated up to 2.4 mg65,66,69–71 (Tables 1 and 2).”
From Incretin-based therapies for the treatment of obesity-related diseases (2024) · cites this paper as [55]
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- Authors
- Gorgojo‐Martínez, J. J., Basagoiti‐Carreño, B., Sanz‐Velasco, A., Serrano‐Moreno, C., & Almodóvar‐Ruiz, F.
- Affiliations
- Unit of Endocrinology and Nutrition Hospital Universitario Fundación Alcorcón Madrid Spain
- Hospital Universitario Fundación Alcorcón (ES)
- Venue
- International Journal of Clinical Practice
- Publisher
- Wiley
- Published
- 2019-08-19
- Volume
- 73
- Issue
- 11
- Pages
- e13399-e13399
- ISSN
- 1368-5031 (ISSN-L)
- 1742-1241
- OpenAlex
- W2967788962
- Cited by
- 82
- References
- 42
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 16 · 2023: 14 · 2022: 12 · 2021: 13 · 2020: 15
- FWCI
- 6.23
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- International Journal of Clinical Practice (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- orlistat, liraglutide, obesity, weight loss, real-world effectiveness, tolerability, prediabetes, cardiovascular risk factors, metabolic risk factors, weight-related comorbidities
- MeSH terms
- Liraglutide, Orlistat, Adult, Female, Humans, Lactones, Life Style, Male, Middle Aged, Obesity, Retrospective Studies, Cohort Studies, Weight Loss, Anti-Obesity Agents, Overweight
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