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I Will Cover...
A Brief introduction to obesity
 Treatments Available
 Background on Orlistat
 Mechanism of action
 Clinics trials
 Advantage of using Orlistat
 Adverse effect
 Conclusion

 A condition associated with the accumulation of excessive
body fat, which leads to a reduction in quality of life
 Obesity is measured by the BMI (body mass index)
measured by the relationship between the wieght and
hieght of an individual.
 An individual to be considered obese their BMI would be
greater than 30 kg/m2
 Obesity is a global issue. Obesity affects 24% of adults
(over 16) and 16% of children (2-16) in England.
[statistics taken in 2006]
 Obesity are linked to other diseases, such as:
hypertension, diabetes, cardiovascular diseases etc..
 These obesity linked diseases are costing the NHS a large
amount of money and a solution is need to solve the
Medical management of obesity

1. Chronic disease
•Serious health
•Major risk factor
for common
causes of death
2. Multiple causes
•Genetic , hormonal
environmental ,
socio - economic ,
•Patient shouldn ’ t be
3. Treatment options blamed for they
outcome of the
•Lifestyle disorder !
•Nutrition / diet
Pharmacological treatment:
( Used in obese patient with BMI ≥ 27 kg / m 2)
oFirst generation Drugs – Most are
-It was designed for long-term therapy
-mechanism of action appetite suppressants
-shown numbers of unpleasant effects such as:
valvular heart defects, addictive, safety problems
e.g fenfluramine

oSecond generation drugs

-Orlistat and Sibutramine
-there are inhibitor drugs
Background on orlistat
Approved in the U.S. FDA in the 1999 and
became available over-the-counter in the UK
on 21st of January 2009 under the name Alli®
market by GSK
It is a synthetic drug
It is derived from lipstatin (isolated from
a bacterium), which is a natural pancreatic
lipase inhibitor.
Its structural formula:
Mechanism of action
o Gastric lipase inhibitor
o Works in the gut to prevent absorption
of fat decrease degradation of ingested
triglycerides into fatty acid
oNon-absorbed triglycerides excreted by gut
oit blocks 30% of dietary fat
Clinic trails
S h o rt tra ils : showed effectiveness of Orlistat
w e ig h t lo ss in co m p a riso n to th e p la ce b o
Lo n g tra ils:
-3 3 0 4 o b e se p a tie n ts in p la ce b o co n tro lle d tria l
-4 ye a rs p e rio d
-O rlista t tre a te d g ro u p h a d a 3 7 % re la tive risk
re d u ctio n in d e ve lo p in g d ia b e te s co m p a re d to
p la ce b o .
-O rlista t h e lp e d w e ig h t lo ss in th e p a tie n t.
Advantages of orlistat
oHighly potent
oA specific irreversible inhibitor of
pancreatic and gastric lipases
oHighly lipophilic and is a non-systemically
acting drug
oSuccessful in both weight loss and
oReduces total cholesterol levels
oSuccessful in treatment of type 2 diabetes

Side effect of Orlistat
Gastrointestinal adverse events are the
most common occurring , it includes:
abdominal pain, oily spotting faeces,
fatty stool, faecal incontinence and
faecal urgency

Decreased absorption of fat-soluble

May be linked to increase risk in cancer
(more studies needs to conducted)
Obesity cannot be controlled or managed
only by the government or health
professionals. The food industry,
international agencies, the media,
communities and individuals need to work
together so that the environment is less
conducive to weight gain.

Pharmacological treatment using Orlistat

to treat obesity shown some evidence for
the short term effectiveness and future
researches are required on the issue of
its long term use saftey.