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Review: several pharmacological therapies promote modest weight loss

Clinical impact ratings GP/FP/Primary care IM/Ambulatory care Endocrine

Key Words: obesity • anti-obesity agents

The first 150 words of the full text of this article appear below.

METHODS
Data sources: Medline (to July 2003), the Cochrane Central Register of Controlled Trials, and existing systematic reviews.

Study selection and assessment: randomised controlled trials that evaluated pharmaceutical agents for weight loss in patients with body mass index 27 kg/m² and reported 6 month weight outcomes. Study quality was assessed using the 5 point Jadad scale (5 = highest quality) and considered study design, method of random assignment, blinding, and withdrawal.

Outcomes: weight loss and side effects.

MAIN RESULTS
The studies meeting inclusion criteria were 3 existing meta-analyses (39 RCTs) evaluating sibutramine, phentermine, and diethylpropion, and 47 RCTs that evaluated orlistat, bupropion, topiramate, and fluoxetine. All comparisons were with placebo, and most trials had a hypocaloric diet cointervention. Meta-analyses were done using random effects. Most medications led to modest weight loss compared with placebo; side effects varied by drug (table).

Kurt A Kennel, MD

Mayo Clinic, Rochester, Minnesota, USA.