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Review: fluoxetine, orlistat, and sibutramine modestly reduce weight in type 2 diabetes

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 Q In patients with type 2 diabetes mellitus, what is the efficacy of pharmacotherapy for weight loss?

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


Embedded ImageData sources:

Medline (1966 to September 2002), EMBASE/Excerpta Medica (1974 to September 2002), CINAHL (1982 to September 2002), Web of Science (1981 to September 2002), Biosis (1970 to September 2002), International Pharmaceutical Abstracts (1970 to September 2002), Cochrane Library (Issue 3, 2002), Cochrane Register of Controlled Trials (Issue 3, 2002), key journals, bibliographies of relevant studies, and contact with experts and drug manufacturers.

Embedded ImageStudy selection and assessment:

published and unpublished studies that used pharmacotherapy as the primary strategy for weight loss in adults with type 2 diabetes and had weight as an outcome. The drugs evaluated were centrally acting appetite suppressants, drugs with a peripheral effect on appetite, drugs that affect nutrient partitioning, and drugs that increase thermogenesis. Drugs withdrawn from the US market or unavailable in the US, investigational drugs and dietary supplements, and metformin and acarbose were excluded. Studies were assessed for quality.

Embedded ImageOutcomes:

changes in weight and glycated haemoglobin concentrations.


59 studies met the inclusion criteria. 14 …

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  • For correspondence: Dr S L Norris, Centers for Disease Control and Prevention, Atlanta, GA, USA. scn5{at}

  • Source of funding: Centers for Disease Control and Prevention.