Long term pharmacotherapy for obesity and overweight: updated meta-analysis
Open accessAbstract
OBJECTIVE: To summarise the long term efficacy of anti-obesity drugs in reducing weight and improving health status. DESIGN: Updated meta-analysis of randomised trials. DATA SOURCES: Medline, Embase, the Cochrane controlled trials register, the Current Science meta-register of controlled trials, and reference lists of identified articles. All data sources were searched from December 2002 (end date of last search) to December 2006. STUDIES REVIEWED: Double blind randomised placebo controlled trials of approved anti-obesity drugs used in adults (age over 18) for one year or longer. RESULTS: 30 trials of one to four years' duration met the inclusion criteria: 16 orlistat (n=10 631 participants), 10 sibutramine (n=2623), and four rimonabant (n=6365). Of these, 14 trials were new and 16 had previously been identified. Attrition rates averaged 30-40%. Compared with placebo, orlistat reduced weight by 2.9 kg (95% confidence interval 2.5 kg to 3.2 kg), sibutramine by 4.2 kg (3.6 kg to 4.7 kg), and rimonabant by 4.7 kg (4.1 kg to 5.3 kg). Patients receiving active drug treatment were significantly more likely to achieve 5% and 10% weight loss thresholds. Orlistat reduced the incidence of diabetes and improved concentrations of total cholesterol and low density lipoprotein cholesterol, blood pressure, and glycaemic control in patients with diabetes but increased rates of gastrointestinal side effects and slightly lowered concentrations of high density lipoprotein. Sibutramine improved [corrected] concentrations of high density lipoprotein cholesterol and triglycerides [corrected] Rimonabant improved concentrations of high density lipoprotein cholesterol and triglycerides, blood pressure, and glycaemic control in patients with diabetes but increased the risk of mood disorders. CONCLUSIONS: Orlistat, sibutramine, and rimonabant modestly reduce weight, have differing effects on cardiovascular risk profiles, and have specific adverse effects.
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Most studies evaluating pharmacotherapy for long-term treatment of overweight and obesity have excluded participants with a history of BS.
“However, most studies evaluating pharmacotherapy for long-term treatment of overweight and obesity have excluded participants with a history of BS [10, 11].”
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- Authors
- Rucker, D., Padwal, R., Li, S. K., Curioni, C., & Lau, D. C. W.
- Affiliations
- University of Alberta (CA)
- University of Calgary (CA)
- Corresponding author
- Padwal, Raj
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2007-11-15
- Volume
- 335
- Issue
- 7631
- Pages
- 1194-1199
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC2128668
- OpenAlex
- W2005136472
- Cited by
- 801
- References
- 26
- Citations by year
- 2026: 9 · 2025: 25 · 2024: 17 · 2023: 25 · 2022: 19 · 2021: 23 · 2020: 32 · 2019: 27 · 2018: 38 · 2017: 32 · 2016: 29 · 2015: 43 · 2014: 45 · 2013: 75 · 2012: 66
- FWCI
- 49.19
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- anti-obesity drugs, obesity, overweight, orlistat, sibutramine, rimonabant, long-term efficacy, weight loss, diabetes mellitus, cardiovascular risk, lipid profile, blood pressure, adverse effects, mood disorders, gastrointestinal adverse effects
- MeSH terms
- Orlistat, Double-Blind Method, Humans, Lactones, Long-Term Care, Obesity, Randomized Controlled Trials as Topic, Anti-Obesity Agents, Overweight
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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