Chances for Orlistat and Sibutramine to Promote Weight Loss
The 2 newest antiobesity drugs to enter the market, orlistat and sibutramine, both promote weight loss when used with a reduced-calorie diet in the long term treatment of obesity. Weight loss is maintained in most patients, but present experience is limited to 1 year with sibutramine and 2 years with orlistat.
The drugs work by very different mechanisms of action - orlistat prevents fat absorption whereas sibutramine enhances satiety - and have disparate tolerability profiles. The most common adverse effects are oily stools, flatus and faecal urgency with orlistat and headache, dry mouth and anorexia with sibutramine. Sibutramine can also increase blood pressure and heart rate.
Neither drug is ideal, and treatment should be selected according to an individual's lifestyle, comorbidities and tolerance of adverse effects. Regardless of which drug is chosen, a carefully managed weight loss programme is essential to optimise drug treatment and minimise indiscriminate drug use.
Currently, the role of drug treatment in obesity is limited, with diet and exercise the cornerstone of therapy [see article entitled 'Obesity: a ballooning disease with no quick fix' Drugs & Therapy Perspectives 2000 Jun 5; 15 (11): 10-13]. Not only is drug therapy costly and often disappointing, but questions about the safety of some older antiobesity agents (dexfenfluramine, fenfluramine) have prompted their withdrawal, and other drugs (e.g. phentermine) are limited to short term use or are not available in some countries.
The launch of 2 new antiobesity drugs, orlistat and sibutramine, has raised hopes for more effective and better tolerated treatment. Both promote and maintain weight loss and are indicated for the long term treatment of obesity in conjunction with reduced-calorie diet.
The 2 newest antiobesity drugs to enter the market, orlistat and sibutramine, both promote weight loss when used with a reduced-calorie diet in the long term treatment of obesity. Weight loss is maintained in most patients, but present experience is limited to 1 year with sibutramine and 2 years with orlistat.
The drugs work by very different mechanisms of action - orlistat prevents fat absorption whereas sibutramine enhances satiety - and have disparate tolerability profiles. The most common adverse effects are oily stools, flatus and faecal urgency with orlistat and headache, dry mouth and anorexia with sibutramine. Sibutramine can also increase blood pressure and heart rate.
Neither drug is ideal, and treatment should be selected according to an individual's lifestyle, comorbidities and tolerance of adverse effects. Regardless of which drug is chosen, a carefully managed weight loss programme is essential to optimise drug treatment and minimise indiscriminate drug use.
Currently, the role of drug treatment in obesity is limited, with diet and exercise the cornerstone of therapy [see article entitled 'Obesity: a ballooning disease with no quick fix' Drugs & Therapy Perspectives 2000 Jun 5; 15 (11): 10-13]. Not only is drug therapy costly and often disappointing, but questions about the safety of some older antiobesity agents (dexfenfluramine, fenfluramine) have prompted their withdrawal, and other drugs (e.g. phentermine) are limited to short term use or are not available in some countries.
The launch of 2 new antiobesity drugs, orlistat and sibutramine, has raised hopes for more effective and better tolerated treatment. Both promote and maintain weight loss and are indicated for the long term treatment of obesity in conjunction with reduced-calorie diet.
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