Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
Physician Assistant Studies
John Cavenagh, PhD, PA-C
OBJECTIVE: To determine whether or not Orlistat ingested prior to a meal causes an increased appetite response.
STUDY DESIGN: A Review of three randomized controlled trials studies from 2003-2008 that were in the English language.
DATA RESOURCES: Randomized controlled trials comparing the effect of Orlistat on satiety were found using PubMed, OVID, and Cochrane databases.
OUTOMES MEASURED: Outcomes measured in the studies were: sensation of appetite, hunger, fullness, nausea, bloating, heartburn, belching, epigastric burning, and prospective food consumption. Each study measured individual patient responses using a VAS (visual analogue scale). Demarchi et al (2004) used a gastric barostat to measure gastric distention and accommodation to a meal. Both Demarchi (2004) and Goedecke et al (2003) measured plasma CCK levels and Ellrichmann et al (2008) measured gherlin, GLP-1, and PYY in addition to CCK. In addition, Ellrichmann et al (2008) used an ultrasound to determine changes in gallbladder size, and gastric emptying using a C sodium-Octanoate breath test.
RESULTS: Results from both the Demarchi (2004) and Goedecke et al (2003) studies did not demonstrate any significant increase in appetite or inhibition of anorexogenic hormones with Orlistat treatment prior to a test meal. The Ellrichmann et al (2008) results demonstrated decreased gallbladder contractility, increased appetite and food consumption.
CONCLUSIONS: The results of whether Orlistat ingested prior to a meal causes an increased appetite response has not been shown in two of the three studies reviewed. Future tests should include varied fat concentrations in a diet and administered to the same subjects with testing trials in longer duration. Orlistat is still an effective dietary aid in the battle against obesity in today’s society.
Boyd, Sandra, "Does the Use of an Oral Lipase Inhibitor (Orlistat) Increase Appetite?" (2012). PCOM Physician Assistant Studies Student Scholarship. 64.