Orlistat  reduced body weight ( weighted mean difference : −2.12 , p < 0.001 ) , total‐cholesterol ( weighted mean difference : −0.30 mmol/L , p < 0.001 ) , low‐density lipoprotein cholesterol ( weighted mean difference : −0.27 mmol/L , p < 0.001 ) , high‐density lipoprotein cholesterol ( weighted mean difference : −0.034 mmol/L , p < 0.001 ) and triglyceride ( weighted mean difference : −0.09 mmol/L , p < 0.001 ) concentrations , while no effect on lipoprotein(a ) was observed .
Total‐ and low‐density lipoprotein cholesterol‐lowering were associated negatively with duration of orlistat treatment and positively with body weight changes .
In conclusion , Orlistat treatment slightly reduces cholesterol and triglyceride levels , but not lipoprotein(a ) levels .
Total‐ and low‐density lipoprotein cholesterol levels reductions are more consistent in patients with greater body weight reduction and shorter duration of orlistat treatment .
We investigated the efficacy of orlistat on plasma lipids and body weight in a meta‐ analysis of 33 studies including 9732  participants .Orlistat  was associated with a slight but significant decrease in body weight , plasma cholesterol and triglyceride concentrations , whereas plasma Lp(a ) levels were not affected by orlistat treatment .
Greater body weight reduction and lower duration of orlistat treatment promoted more consistent plasma total‐ and LDL‐cholesterol lowering
& NA ; Orlistat , an inhibitor of intestinal lipase , promotes body weight reduction .
The lipid‐lowering efficacy of orlistat is controversial and the effect of orlistat‐induced body weight reduction on lipid changes has not been explored in meta‐regression analyses .
HighlightsOrlistat is an inhibitor of intestinal lipase promoting body weight reduction , but whose lipid‐lowering efficacy is controversial .
The effects of orlistat on weight and on serum lipids in obese patients with hypercholesterolemia: a randomized, double-blind, placebo-controlled, multicentre study
OBJECTIVE : Assessment of the effects of orlistat 120 mg three times daily vs placebo on weight loss and serum lipids in obese hypercholesterolemic patients . DESIGN : A 24 week multicentre , double-blind , r and omized , placebo-controlled trial . After a 2-week single-blind run-in period ( placebo+diet ( −600 kcal/day ; ≤30 % of calories as fat ) ) , 294 patients were su bmi tted to the hypocaloric diet and r and omly assigned to either orlistat 120 mg or placebo three times daily . Patients who completed the double-blind study ( n=255 ) were eligible for participation in a subsequent 24 week open-label orlistat extension phase . SUBJECTS : Patients with body mass index ( BMI ) 27–40 kg/m2 and hypercholesterolemia ( low-density-lipoprotein cholesterol , LDL-C , 4.1–6.7 mmol/l ) . MEASUREMENTS : Efficacy assessment s included weight loss , lipid levels , other cardiovascular risk factors and anthropometric parameters . Safety assessment s. RESULTS : Weight loss during run-in was similar in both groups . After r and omization , orlistat-treated patients lost significantly more weight  than placebo recipients : mean percentage weight loss from start of run-in to week 24 was−6.8 % in the orlistat group and −3.8 % in the placebo group ( P<0.001 ) . Moreover , more patients in the orlistat group than in the placebo group achieved clinical ly meaningful weight loss of ≥5 % ( 64 vs 39 % ) or ≥10 % ( 23 vs 13 % ) at week 24 . Treatment with orlistat was associated with significantly greater changes in total cholesterol ( −11.9 % vs −4.0 % ; P<0.001 ) and LDL-C ( −17.6 vs −7.6 % ; P<0.001 ) . For any category of weight loss during the double-blind treatment period , change in LDL-C was more pronounced in orlistat-treated patients than in placebo recipients , indicating that orlistat had a direct cholesterol-lowering effect that was independent of weight reduction ( P<0.001 ) . Adjunction of orlistat during the extension phase in patients who initially received placebo  induced a further decrease in weight , total cholesterol and LDL-C. Orlistat was generally well tolerated with a safety profile comparable to placebo , with the exception of a higher incidence of gastrointestinal events ( ≥1 event in 64 vs 38 % of patients ) . CONCLUSION : Orlistat as an adjunct to dietary intervention promotes weight loss and reduces LDL-C beyond the effect of weight loss in overweight or obese patients with concomitant hypercholesterolemia
Orlistat  reduced body weight ( weighted mean difference : −2.12 , p < 0.001 ) , total‐cholesterol ( weighted mean difference : −0.30 mmol/L , p < 0.001 ) , low‐density lipoprotein cholesterol ( weighted mean difference : −0.27 mmol/L , p < 0.001 ) , high‐density lipoprotein cholesterol ( weighted mean difference : −0.034 mmol/L , p < 0.001 ) and triglyceride ( weighted mean difference : −0.09 mmol/L , p < 0.001 ) concentrations , while no effect on lipoprotein(a ) was observed .
Total‐ and low‐density lipoprotein cholesterol‐lowering were associated negatively with duration of orlistat treatment and positively with body weight changes .
In conclusion , Orlistat treatment slightly reduces cholesterol and triglyceride levels , but not lipoprotein(a ) levels .
Total‐ and low‐density lipoprotein cholesterol levels reductions are more consistent in patients with greater body weight reduction and shorter duration of orlistat treatment .
We investigated the efficacy of orlistat on plasma lipids and body weight in a meta‐ analysis of 33 studies including 9732  participants .Orlistat  was associated with a slight but significant decrease in body weight , plasma cholesterol and triglyceride concentrations , whereas plasma Lp(a ) levels were not affected by orlistat treatment .
Greater body weight reduction and lower duration of orlistat treatment promoted more consistent plasma total‐ and LDL‐cholesterol lowering
& NA ; Orlistat , an inhibitor of intestinal lipase , promotes body weight reduction .
The lipid‐lowering efficacy of orlistat is controversial and the effect of orlistat‐induced body weight reduction on lipid changes has not been explored in meta‐regression analyses .
HighlightsOrlistat is an inhibitor of intestinal lipase promoting body weight reduction , but whose lipid‐lowering efficacy is controversial .