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Several years ago, researchers showed that orlistat, which inhibits fat absorption, promoted weight reduction in diabetic patients (Journal Watch Aug 21 1998). Since that time, metformin has become a popular treatment for overweight type 2 diabetic patients, because it seems to induce less weight gain than do other diabetes drugs. Because both orlistat and metformin have prominent gastrointestinal (GI) side effects, it is logical to assess the tolerability of the 2 drugs together.
Industry-sponsored researchers randomized 504 overweight or obese type 2 diabetic patients, all of whom were taking metformin, to receive either orlistat or placebo 3 times daily. During 1 year of treatment, mean weight loss was significantly greater with orlistat …