Being overweight increases the risk of a variety of health problems, including type 2 diabetes, high cholesterol levels, and low self-esteem. Even though getting to a healthy weight is a crucial part of treating obesity in teens, it's not an easy task. Researchers from British Columbia Children's Hospital in Vancouver, Canada, Children's Mercy Hospital in Kansas City, Missouri, Baylor College of Medicine in Houston, Texas, and Hoffman-La Roche Inc., in Nutley, New Jersey, examined whether a weight-loss medicine called orlistat could make losing weight easier for overweight teens.
Orlistat is a drug that decreases the body's ability to absorb fat by up to 30%. Even though orlistat is approved for use in overweight and obese adults, the safety and effectiveness of the drug haven't been studied in kids and teens. In this study conducted between August 2000 and October 2002, 539 obese teens (teens whose body weights were above the 95th percentile) were divided into two groups: One group received orlistat three times daily, whereas the other group took an inactive placebo pill three times a day. The teens and their parents didn't know which pill the teen was taking. During the 54-week study period, the teens also ate a low-calorie diet and were instructed about how to lose weight in a healthy way. Participants spoke with a dietician at every visit and were involved in behavioral modification programs that included techniques like recording food intake and activity, limiting high-calorie foods, eating more slowly, and avoiding snacking. The teens were also encouraged to exercise regularly. Both groups of teens underwent height, weight, hip and waist measurements, blood pressure screening, and blood and other testing to determine how the program was affecting their overall health and weight.
During the first 3 months of the study, both groups of teens lost weight and reduced their body mass index measurements (body mass index is an indirect measure of body fat). After the initial 3 months, BMI leveled out in teens taking orlistat, but went on to increase in the teens taking the placebo. At the end of the study, about 27% of the teens taking orlistat had a 5% or higher decrease in BMI, compared to only 16% of the teens taking the placebo. In addition, more than 13% of the teens taking orlistat reduced their BMI by 10% or more, compared to only 5% of the teens taking the placebo. On average, teens taking orlistat decreased the size of their waists, but teens taking the placebo had increased weight circumference.
Teens who took orlistat did report mild to moderate gastrointestinal problems, like fatty/oily stool, flatulence, and abdominal pain, more frequently than teens who took the placebo. Two percent of the teens in the study dropped out because of the side effects of the weight-loss drug.
What This Means to You: According to the results of this study, orlistat effectively helped obese teens lose weight when combined with a reduced-calorie diet, exercise, and a behavior modification program. Teens who are overweight or obese and are involved in a comprehensive weight management program may benefit from this medication. Additional studies, however, are necessary to determine the long-term safety and efficacy of orlistat in children. Talk to your child's doctor if you have questions about your child's weight.
Source: Jean-Pierre Chanoine, MD, PhD; Sarah Hampl, MD, FAAP; Craig Jensen, MD; Mark Boldrin, MS; Jonathan Hauptman, MD; Journal of the American Medical Association, June 15, 2005
Reviewed by: Mary L. Gavin, MD
Date reviewed: August 2005