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No specific therapy has been identified for the treatment of nonalcoholic steatohepatitis (NASH), but evidence suggests that weight loss in overweight patients reduces steatosis and insulin resistance (Gut 2007; 56:1760). Orlistat, a reversible inhibitor of gastric and pancreatic lipase, blocks the absorption of triglycerides and has been shown, in association with a low-fat diet, to reduce body-mass index (BMI). To assess whether orlistat can improve liver histology, researchers at two U.S. tertiary care centers conducted a randomized study involving 41 overweight (BMI, ≥27 kg/m2) patients with biopsy-proven NASH.
Patients were randomized to a diet of 1400 calories daily plus vitamin E (800 IU daily) with or without orlistat (120 mg 3 times…