Drugs

The most commonly prescribed medication for obesity resistance exercise / diet is orlistat (Xenical, which reduces intestinal fat sitting inhibiting pancreatic lipase) and sibutramine (Reductil, Meridia, a anorectics).

Weight loss with these drugs is modest and long-term average weight loss with orlistat is 2.9 kg, 4.2 kg with sibutramine and 4.7 kg with rimonabant. Orlistat and rimonabant led to a reduction in the incidence of diabetes, and all drugs have some effect on lipoprotein (different forms of cholesterol).

However, little information exists on long-term complications of obesity such as heart attacks. All drugs have potential side effects and contraindications. Commonly drug for weight loss are used for a period of time (eg three months) and was discontinued or changed by other people if the benefit has not been obtained, as a weight loss of less than 5% of total body weight.

A meta-analysis of randomized controlled studies conducted by the International Cochrane Collaboration, concluded that in diabetics fluoxetine, orlistat and sibutramine, could achieve a modest but significant weight loss between 12-57 weeks, with long-term health is not very clear.

Obesity may also influence the choice of drugs for the treatment of diabetes. The metformin can lead to a slight weight reduction (as opposed to sulfonylureas and insulin) and has been shown to reduce the risk of cardiovascular disease in type two diabetics are obese. The tiazolidinodionas can cause slight weight gain but decrease the "pathologic" abdominal fat and can therefore be used in diabetic patients with central obesity.

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