Abstract
Background: Overweight and obesity are reaching epidemic proportions, and a variety of therapeutic countermeasures is needed. This article describes a support programme for orlistat.
Methods: Physicians who prescribed orlistat could refer their patients to a support programme provided by the manufacturer. A clinical nutritionist evaluated the patient’s diet and gave advice and motivational support during approximately seven telephone consultations a year.
Design: A cohort study.
Results: Of 3526 patients (81.5% women and 18.5% men) whose first contact with the nutritionist was recorded between April 2001 and July 2004, 3023 had at least one follow-up consultation. The mean initial body mass index (BMI) was 33.7 (SD 9.0). Of men and women, 90% and 80%, respectively, met the Norwegian Pharmaceutical Product Compendium criteria for orlistat. The remaining patients had a BMI that was too low or no reported risk factors. Of the 2456 patients who reported their weight at two or more consultations, 70% achieved a ≥5% weight loss. Patients who took part in the programme for 4.5 months or more, and reported their weight at two or more consultations (n=1891, 62.5%), had a mean weight reduction of 9.1% (95% confidence interval 7.8 to 10.4%) of the initial weight.
Conclusion: The combination of telephone advice provided by a clinical nutritionist and orlistat had a clinically significant effect among over two-thirds of patients who reported their weight. Use of orlistat largely followed medical recommendations with regard to the target population.
We would like to thank the following nutritionists who worked in the follow-up programme: Ellen-Margrethe Hovland, Janne Langehaug Antonsen, Kathrine C Haavardsholm, Merete Helgeland, Siv Tone Natland, Kristin Holvik, Marianne Tronrud and dietary adviser Mette Strøm. We would also like to thank Gunnar Hansen for care of the database, as well as all the physicians who referred patients to the programme. The study was sponsored in its entirety by Roche Norge AS.
Reported conflicts of interest: Kathrin Kobbevik and Unni Gisletun are employed by Roche. Fredrik Hansson is an independent statistical consultant who was paid by Roche for the assignment. Serena Tonstad has received honoraria from Roche, Abbott and other pharmaceutical companies for lectures.