It is well known that teen obesity is a growing public health issue. In addition to suffering psychological stigma, obese adolescents are at greater risk for developing Type II diabetes and high cholesterol, and ultimately becoming obese adults. Standard weight-loss programs that emphasize diet, exercise, and behavior modification often frustrate both physicians and patients. Orlistat, a medication that inhibits fat absorption during digestion, has been shown to help adults lose weight. Researchers from 32 centers around the United States and Canada investigated whether this medicine could safely treat adolescent obesity too.

What the researchers wanted to know: Can orlistat help obese teens lose weight safely?

What they did: Researchers divided over 500 obese teens into two groups. For about a year, one group received orlistat while the other received placebo pills. Researchers encouraged all participants to exercise, follow low-calorie diets, and take part in programs that helped them assess their relationships with food. They also charted the participants' changing BMI (body mass index), a ratio of weight to height that indicates degree of obesity. Researchers also used blood tests to measure levels of blood sugar, cholesterol, and certain hormones. Patients reported any side effects or changes in their health during the study.

What they found: In the beginning, BMIs of participants in both groups decreased, and patients became thinnest at about 12 weeks into the study. But by the end of the year, those in the placebo group were slightly more obese than they were when they started. On the other hand, those taking orlistat, while increasing their BMI from the low point, completed the study thinner than they were at the beginning. In addition, more patients taking orlistat reduced their BMI by at least 5 or 10 percent than those taking placebo pills. Participants did not seem to experience serious medical problems directly related to orlistat use. Minor side effects reported included oily stools and abdominal pain, both more frequently experienced by those taking orlistat.

What this study means to you: Orlistat may help obese teens lose weight safely. Taking the medication could be a component of a weight-loss plan that includes exercising regularly and eating a low-calorie diet. Patients and physicians together need to evaluate the risks and benefits of starting orlistat therapy.

Caveats: Since orlistat causes one to absorb less fat–and thus fewer calories–during digestion, patients often regain weight after stopping the medication. More research is needed to see if long-term orlistat use in teens is both safe and necessary to keep pounds off. In addition, in that most of the patients in the study were both white and female, one needs to be cautious in applying the results to male patients and those of other ethnicities.

Find out more: The National Institutes of Health has a page on childhood obesity. It has links for calculating BMI in addition to information on diagnosis and treatment.

Read the article: Chanoine, Jean-Pierre, et al. "Effect of Orlistat on Weight and Body Composition in Obese Adolescents: A Randomized Controlled Trial." JAMA. June 15, 2005, Vol. 293, No. 23, pp. 2873-2883.

Abstract online: http://jama.ama-assn.org