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Q How effective and safe are pharmacological therapies in the treatment of obesity?
Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ IM/Ambulatory care ★★★★★☆☆ Endocrine ★★★★★☆☆
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 …
Footnotes
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For correspondence: Dr Z Li, West LA Veterans Affairs Medical Center, Los Angeles, CA, USA. zhaoping.limed.va.gov
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Source of funding: Agency for Healthcare Quality and Research.
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Abstract and commentary also appear in ACP Journal Club.