Impact of carbohydrate and fat intake on weight-reducing efficacy of orlistat

Abstract

Background: Orlistat treatment of obesity results in a poor long-term weight loss (< 5%) in about 30% of patients. Aim: Total energy and macronutrient intake were examined to assess the effect of a change in eating habits on weight loss. Methods: Sixty-two patients consumed a hypocaloric diet, together with orlistat (3 x 120 mg/day), for 72 weeks, with a maximal fat allowance of 30% of the energy intake. At regular intervals, food diaries were recorded. Results: Fifty-six patients completed the study and lost 8.5 ± 0.88 kg (P < 0.001). Energy intake was 1500 kcal/day during the entire study period. In three sub-groups established according to weight loss (1, < 5%; 2, > 5% and < 10%; 3, > 10%), fat intake was within the recommended range in all groups during the first 6 months, but thereafter only in group 3. All groups increased their carbohydrate consumption, with the greatest increase in group 1, which could account for the rapid regain of initially lost body weight in this group. Conclusion: At the beginning of a weight management programme in conjunction with orlistat, a low fat intake is advised for an efficient reduction in body weight. Subsequently, in patients with poor long-term weight loss, dietary recommendations must also consider carbohydrate restriction to ensure an adequate hypocaloric diet.