Clinical Brief
Long-term Maintenance of Weight Loss after a Low-Calorie Diet: A Randomized Blinded Trial of the Efficacy and Tolerability of Sibutramine
Source: Apfelbaum M, et al. Am J Med 1999;106:179-184.
Although low-calorie diets (< 800 calories daily) have proven beneficial over the short term, maintenance of weight loss remains problematic. There have been few trials of pharmacotherapy combined with a low-calorie diet. The current study is a 12-month, double-blind trial of sibutramine in addition to a very low calorie diet for obesity.
Study subjects (n = 160) were required to have a baseline body mass index greater than 30. After a four-week, low-calorie diet, subjects were given sibutramine 10 mg daily, and their diet was changed to a reduced calorie intake calculated to be 20-30% less than their pre-study diet. Subjects were followed monthly for one year.
The placebo recipients gained an average of 0.5 kg over 12 months, compared with a 5.2 kg loss in recipients of sibutramine. Also, sibutramine treatment was associated with favorable changes in triglyceride and HDL levels when compared with placebo. Sibutramine treatment was associated with greater likelihood of maintaining more than 50% of initial weight loss than placebo. Withdrawal from treatment was infrequent (4%) but twice as common among placebo recipients. Apfelbaum and colleagues conclude that sibutramine is effective in maintaining, and even enhancing, weight loss after a low-calorie diet. (The Clinical Brief was written by Dr. Louis Kuritzky, Courtesy Clinical Assistant Professor, University of Florida, Gainesville, FL.)
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