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Review: several pharmacological therapies promote modest weight loss

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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 ★★★★★☆☆


Embedded ImageData sources:

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

Embedded ImageStudy 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.

Embedded ImageOutcomes:

weight loss and side effects.


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 …

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