作者：James O Hill, Jonathan Hauptman, James W Anderson, Ken Fujioka, Patrick M O’Neil, Diane K Smith, James H Zavoral, and Louis J Aronne.
作者單位：
James O Hill：美國丹佛科羅拉多大學健康科學中心；
Jonathan Hauptman：美國羅氏制藥股份有限公司，新澤西州；
James W Anderson：美國列克星敦肯塔基州退伍軍人事務醫(yī)學中心；
Ken Fujioka：西班牙圣地亞哥斯克利普斯臨床中心；
Patrick M O’Neil：美國南卡羅來納醫(yī)科大學精神行為科學部體重管理中心；
Diane K Smith：美國喬治亞州企業(yè)社會健康責任同盟會；
James H Zavoral：美國明尼蘇達州心血管預防研究所；
Louis J Aronne：美國紐約康奈爾大學醫(yī)學院。
【摘自】美國臨床營養(yǎng)雜志，1998年第69期。
【摘要】
背景：在肥胖治療中，長期減肥在治療上依然是一個挑戰(zhàn)。
目的：多中心、雙盲、安慰劑對照研究的目地是假設奧利司他在防止體重反彈方面比安慰劑更有效。
設計：6個月內體重在原來基礎上減少了8%以上，并且期間引入規(guī)定的低熱量飲食，沒有輔助其他藥物治療的肥胖受試者被隨機分配服用安慰劑、30mg奧利司他、60mg奧利司他或120mg奧利司他，每日三次并持續(xù)1年，結合飲食控制以防止體重反彈。在招募的1313名BMI指數(shù)在28~43之間的受試者中，有729名受試者在6個月內減肥周期內減掉了8%以上的體重，并這729名受試者進入雙盲實驗階段。
結果：試驗結束1年后，每日3次服用120mg奧利司他的受試者增長的體重為(32.8±4.5%)，服用安慰劑組的受試者增長的體重為(58.7±5.8%)，前者比后者增長的范圍小。此外，服用120mg奧利司他的受試者比安慰劑組增長的體重要小25%(47.5%比29.9%)。此外，每日3次服用120mg的奧利司他在降低低密度脂蛋白和膽固醇水平方面明顯要大于安慰劑組。
結論：在體重的維持期間，奧利司他的使用能夠將體重的波動降到最低并能有效改善和肥胖相關的其他風險因子。
文獻原文：
Orlistat, a lipase inhibitor, for weight maintenance after conventional dieting : a 1 year study
Author： James O Hill, Jonathan Hauptman, James W Anderson, Ken Fujioka, Patrick M O’Neil, Diane K Smith, James H Zavoral, and Louis J Aronne
Author Affiliations：
James O Hill: University of Colorado Health Sciences Center, Denver ;
Jonathan Hauptman: Hoffmann-La Roche Inc, Nutley, NJ ;
James W Anderson: The Veterans Affairs Medical Center, Lexington, KY;
Ken Fujioka: Scripps Clinical Foundation, San Diego;
Patrick M O’Neil: The Weight Management Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston;
Diane K Smith: CSRA Partners in Health, Augusta, GA;
James H Zavoral: The Preventive Cardiology Institute, Edina, MN;
Louis J Aronne: Cornell University Medical College, New York.
Quote：The American Journal of Clinical Nutrition. 1998;69:1108-1116
【ABSTRACT】
Background: Long-term maintenance of weight loss remains a therapeutic challenge in obesity treatment.
Objective: This multicenter, double-blind, placebo-controlled study was designed to test the hypothesis that orlistat, a gastrointestinal lipase inhibitor, is significantly more effective than a placebo in preventing weight regain.
Design：Obese subjects who lost ≥8% of their initial body weight during a 6-mo lead-in of a prescribed hypoenergetic diet (4180-kJ/d deficit) with no adjunctive pharmacotherapy were randomly assigned to receive placebo, 30 mg orlistat, 60 mg orlistat, or 120 mg orlistat 3 times daily for 1 y in combination with a maintenance diet to help prevent weight regain. Of 1313 recruited subjects [body mass index (in kg/m2): 28–43], 729 subjects lost ≥8% of their initial body weight during the 6-mo weight-loss lead-in period and were enrolled in the double-blind phase.
Results：After 1 y, subjects treated with 120 mg orlistat 3 times daily regained less weight than did placebo-treated subjects (32.8 ± 4.5% compared with 58.7 ± 5.8% regain of lost weight; P < 0.001). Moreover, more subjects in the 120-mg orlistat group than in the placebo group regained ≤25% of lost weight (47.5% of subjects compared with 29.9%). In addition, orlistat treatment (120 mg 3 times daily) was associated with significantly greater reductions in total and LDL-cholesterol concentrations than was placebo (P < 0.001).
Conclusion：The use of orlistat during periods of attempted weight maintenance minimizes weight readjustment and facilitates long-term improvement in obesity-related disease risk factors.