Wadden T A, Berkowitz R I, Womble L G, Sarwer D B, Arnold M E, Steinberg C M
University of Pennsylvania School of Medicine, Department of Psychiatry, Philadelphia 19104, USA.
Obes Res. 2000 Sep;8(6):431-7. doi: 10.1038/oby.2000.53.
This study assessed whether adding orlistat to sibutramine would induce further weight loss in patients who previously had lost weight while taking sibutramine alone.
Patients were 34 women with a mean age of 44.1 +/- 10.4 years, weight of 89.4 +/- 13.8 kg, and body mass index (BMI) of 33.9 +/- 4.9 kg/m2 who had lost an average of 11.6 +/- 9.2% of initial weight during the prior 1 year of treatment by sibutramine combined with lifestyle modification. Patients were randomly assigned, in double-blind fashion, to sibutramine plus orlistat or sibutramine plus placebo. In addition to medication, participants were provided five brief lifestyle modification visits during the 16-week continuation trial.
Mean body weight did not change significantly in either treatment condition during the 16 weeks. The addition of orlistat to sibutramine did not induce further weight loss as compared with treatment by sibutramine alone (mean changes = +0.1 +/- 4.1 kg vs. +0.5 +/- 2.1 kg, respectively).
These results must be interpreted with caution because of the study's small sample size. The findings, however, suggest that the combination of sibutramine and orlistat is unlikely to have additive effects that will yield mean losses > or =15% of initial weight, as desired by many obese individuals.
本研究评估在曾单独服用西布曲明时已减重的患者中，加用奥利司他至西布曲明是否会带来进一步体重减轻。
患者为34名女性，平均年龄44.1±10.4岁，体重89.4±13.8千克，体重指数（BMI）为33.9±4.9千克/平方米，这些患者在之前1年接受西布曲明联合生活方式干预治疗期间平均减重初始体重的11.6±9.2%。患者以双盲方式随机分配至西布曲明加奥利司他组或西布曲明加安慰剂组。在为期16周的延续试验中，除药物治疗外，参与者还接受了5次简短的生活方式干预访视。
在16周期间，两种治疗情况下平均体重均未出现显著变化。与单独使用西布曲明治疗相比，西布曲明加用奥利司他并未带来进一步体重减轻（平均变化分别为+0.1±4.1千克和+0.5±2.1千克）。
由于本研究样本量小，这些结果必须谨慎解读。然而，研究结果表明，西布曲明与奥利司他联合使用不太可能产生相加效应，从而达到许多肥胖个体所期望的平均体重减轻≥初始体重15%的效果。
