Obesity is closely related to type 2 diabetes and long-term weight reduction is an important part of the care delivered to obese persons with diabetes.

Researchers of the National Center for Chronic Disease Prevention & Health Promotion, CDC, Atlanta, assessed the efficacy of pharmacotherapy for weight loss in adults with type 2 diabetes.

Twenty two randomized controlled trials were included in the review, with a total of 296 participants for Fluoxitine ( Prozac ), 2036 for Orlistat ( Xenical ), and 1047 for Sibutramine ( Reductil / Meridia ).

Pharmacotherapy produced modest reductions in weight for Fluoxetine ( 5.1 kg ) at 24 to 26 weeks follow up; Orlistat 2.0 kg at 12 to 57 weeks follow-up, and Sibutramine 5.1 kg at 12 to 52 weeks follow-up.

Glycated hemoglobin also modestly and significantly reduced for Fluoxetine and Orlistat.

Gastrointestinal side effects were common with Orlistat; tremor, somnolence and sweating with Fluoxetine; and palpitations with Sibutramine.

“ Fluoxetine, Orlistat, and Sibutramine can achieve statistically significant weight loss over 12 to 57 weeks. The magnitude of weight loss is modest, however, and the long-term health benefits remain unclear. The safety of Sibutramine is uncertain. There is a paucity of data on other drugs for weight loss or control in persons with type 2 diabetes,” the authors conclude.

Norris SL et al, Cochrane Database Syst Rev 2005:CD004096


XagenaMedicine2005