作者：James O Hill, Jonathan Hauptman, James W Anderson, Ken Fujioka, Patrick M O’Neil, Diane K Smith, James H Zavoral, and Louis J Aronne.
作者单位：
James O Hill：美国丹佛科罗拉多大学健康科学中心；
Jonathan Hauptman：美国罗氏制药股份有限公司，新泽西州；
James W Anderson：美国列克星敦肯塔基州退伍军人事务医学中心；
Ken Fujioka：西班牙圣地亚哥斯克利普斯临床中心；
Patrick M O’Neil：美国南卡罗来纳医科大学精神行为科学部体重管理中心；
Diane K Smith：美国乔治亚州企业社会健康责任同盟会；
James H Zavoral：美国明尼苏达州心血管预防研究所；
Louis J Aronne：美国纽约康奈尔大学医学院。
【摘自】美国临床营养杂志，1998年第69期。
【摘要】
背景：在肥胖治疗中，长期减肥在治疗上依然是一个挑战。
目的：多中心、双盲、安慰剂对照研究的目地是假设奥利司他在防止体重反弹方面比安慰剂更有效。
设计：6个月内体重在原来基础上减少了8%以上，并且期间引入规定的低热量饮食，没有辅助其他药物治疗的肥胖受试者被随机分配服用安慰剂、30mg奥利司他、60mg奥利司他或120mg奥利司他，每日三次并持续1年，结合饮食控制以防止体重反弹。在招募的1313名BMI指数在28~43之间的受试者中，有729名受试者在6个月内减肥周期内减掉了8%以上的体重，并这729名受试者进入双盲实验阶段。
结果：试验结束1年后，每日3次服用120mg奥利司他的受试者增长的体重为(32.8±4.5%)，服用安慰剂组的受试者增长的体重为(58.7±5.8%)，前者比后者增长的范围小。此外，服用120mg奥利司他的受试者比安慰剂组增长的体重要小25%(47.5%比29.9%)。此外，每日3次服用120mg的奥利司他在降低低密度脂蛋白和胆固醇水平方面明显要大于安慰剂组。
结论：在体重的维持期间，奥利司他的使用能够将体重的波动降到最低并能有效改善和肥胖相关的其他风险因子。
文献原文：
Orlistat, a lipase inhibitor, for weight maintenance after conventional dieting : a 1 year study
Author： James O Hill, Jonathan Hauptman, James W Anderson, Ken Fujioka, Patrick M O’Neil, Diane K Smith, James H Zavoral, and Louis J Aronne
Author Affiliations：
James O Hill: University of Colorado Health Sciences Center, Denver ;
Jonathan Hauptman: Hoffmann-La Roche Inc, Nutley, NJ ;
James W Anderson: The Veterans Affairs Medical Center, Lexington, KY;
Ken Fujioka: Scripps Clinical Foundation, San Diego;
Patrick M O’Neil: The Weight Management Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston;
Diane K Smith: CSRA Partners in Health, Augusta, GA;
James H Zavoral: The Preventive Cardiology Institute, Edina, MN;
Louis J Aronne: Cornell University Medical College, New York.
Quote：The American Journal of Clinical Nutrition. 1998;69:1108-1116
【ABSTRACT】
Background: Long-term maintenance of weight loss remains a therapeutic challenge in obesity treatment.
Objective: This multicenter, double-blind, placebo-controlled study was designed to test the hypothesis that orlistat, a gastrointestinal lipase inhibitor, is significantly more effective than a placebo in preventing weight regain.
Design：Obese subjects who lost ≥8% of their initial body weight during a 6-mo lead-in of a prescribed hypoenergetic diet (4180-kJ/d deficit) with no adjunctive pharmacotherapy were randomly assigned to receive placebo, 30 mg orlistat, 60 mg orlistat, or 120 mg orlistat 3 times daily for 1 y in combination with a maintenance diet to help prevent weight regain. Of 1313 recruited subjects [body mass index (in kg/m2): 28–43], 729 subjects lost ≥8% of their initial body weight during the 6-mo weight-loss lead-in period and were enrolled in the double-blind phase.
Results：After 1 y, subjects treated with 120 mg orlistat 3 times daily regained less weight than did placebo-treated subjects (32.8 ± 4.5% compared with 58.7 ± 5.8% regain of lost weight; P < 0.001). Moreover, more subjects in the 120-mg orlistat group than in the placebo group regained ≤25% of lost weight (47.5% of subjects compared with 29.9%). In addition, orlistat treatment (120 mg 3 times daily) was associated with significantly greater reductions in total and LDL-cholesterol concentrations than was placebo (P < 0.001).
Conclusion：The use of orlistat during periods of attempted weight maintenance minimizes weight readjustment and facilitates long-term improvement in obesity-related disease risk factors.