comes in relation to glucose-insulin homeostasis
than placebo during 3 years,
but very similar effects between the two
groups were observed concerning
changes in lipids and blood pressure
(Table 2). Total and LDL cholesterol
plus triglycerides were significantly reduced
after the VLED-induced major
weight loss, but in contrast to several
other studies of orlistat (18) there were
no additional effects of orlistat on these
lipids in the present study. Thus, the
effects of orlistat on risk factors seemed
to be less pronounced than shown in
several other studies (10,18–20). Because
we allowed supplementary treatment
with antidiabetes medications,
statins, and antihypertensive medications,
it could be suggested that this comedication
may have influenced the
result. This possibility cannot completely
be excluded, but the number of
subjects who were on medication for
these risk factors was similar between
the two groups during the study. Another
explanation could be that the improvement
in all risk factors induced
after the VLED treatment was so pronounced
that the possible specific beneficial
effect of orlistat observed in many
other studies might be somehow obscured
by these initial large weight loss.
Finally, compared with several other
placebo-controlled studies (21–23), the
lifestyle intervention alone plus placebo
was markedly effective in the present
study