Orlistat before and after Orlistat (brand name: alli) is the only OTC medication that is FDA approved for weight loss in conjunction with reduced calorie intake. Is indicated for overweight adults aged 18 years or older in conjunction with a reduced-calorie, low-fat diet.
Orlistat does not act systemically; instead, it exerts its therapeutic activity in the lumen of the stomach and small intestine by inhibiting gastric and pancreatic lipases that hydrolyze triglycerides into free fatty acids and monoglycerides. This restricts the intestine’ s ability to absorb triglycerides, which are excreted fecally instead, thus inhibiting absorption of dietary fats by approximately 30%.
In a 16-week randomized, controlled study, orlistat 60 mg resulted in significant weight loss compared with placebo (3.05 kg vs. 1.9 kg; P <.001) in mildly to moderately overweight adults.16 Another study evaluated the ability of orlistat 60 mg to produce a change in visceral adipose tissue in overweight patients.17 After 24 weeks, orlistat demonstrated a significant decrease in visceral adipose tissue versus placebo ( â&#x20AC;&#x201C; 15.7% vs. â&#x20AC;&#x201C; 9.4%; P <.05). In addition, there was a trend toward a greater reduction in liver fat (which is independently linked to dyslipidemia and insulin resistance)
and intermuscular adipose tissue (which is associated with metabolic
abnormalities
related
to
muscle
and
glucose
metabolism).These findings suggest that orlistat 60 mg, along with a reduced-calorie, low-fat diet, may be an effective weight-loss tool for reducing metabolic risk factors associated with upper-body adiposity.
Reference 1. Garcia S, da Costa Barros L, Turatti A, Martinello F, Modiano P, Ribeiro-Silva A, de Oliveira Vespúcio M, Uyemura S (2006). "The anti-obesity agent Orlistat is associated to increase in colonic preneoplastic markers in rats treated with a chemical carcinogen". Cancer Lett. 240 (2): 221–4. doi:10.1016/j.canlet.2005.09.011. PMID 16377080. 2. Takayama T, Katsuki S, Takahashi Y, Ohi M, Nojiri S, Sakamaki S, Kato J, Kogawa K, Miyake H, Niitsu Y (1998). "Aberrant crypt foci of the colon as precursors of adenoma and cancer". N Engl J Med. 339 (18): 1277–84. doi:10.1056/NEJM199810293391803. PMID 9791143. 3. "Vitamin A". 4. Zhi J, Moore R, Kanitra L, Mulligan TE (2003). "Effects of orlistat, a lipase inhibitor, on the pharmacokinetics of three highly lipophilic drugs (amiodarone, fluoxetine, and simvastatin) in healthy volunteers". J Clin
Pharmacol. 43 (4): 428â&#x20AC;&#x201C;35. doi:10.1177/0091270003252236. PMID 12723464.
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