TABLE 3.
Weight outcomes (body weight change and categorical body weight loss) reported in included studies
| Study | Patient population | Baseline weight, kg | Weight change a | Categorical body weight loss | |
|---|---|---|---|---|---|
| kg | % | ||||
| ORLISTAT: PROSPECTIVE COHORTS | |||||
| Hollywood and Ogden 14 | General obesity | NR | −4.09 (6.21) kg at 6 months | ||
| Schwartz et al. 17 | 88.6 (19.5) kg | −4.6 (0.7) kg at > 60 days | > 5%: > 60 day, 46.3% | ||
| Wirth 18 | 99.2 kg | −10.8 (6.9) kg at 6–9 months (all patients) | 6–9 months: all patients, −10.7%; ORL alone, −9.4%; + WL program, −10.8%; +diet, −9.5%; + exercise, −10.6%; + diet + exercise, −11.4%; +all adjunct measures, −12.0% | 5–10%: 6–9 months, 35.8% (all patients) | |
| Rowe et al. 16 | DM (91% T2DM) | F, 98.1 (18.0) kg; M, 126.2 (23.7) kg | −7.1 kg at 6 months (p < 0.001 vs. baseline) | −6.2% at 6 months | > 5%: 6 months, 51.2% |
| ORLISTAT: RETROSPECTIVE COHORTS | |||||
| Ahn et al. 23 | General obesity | 79.3 (14.1) kg | −3.0 (2.0) kg at 12 weeks; −3.6 (2.9) kg at 24 weeks (p < 0.001 vs. baseline both time points) | −3.8% at 12 weeks; −4.6% at 24 weeks (p < 0.001 vs. baseline both time points) |
5–10%: 12 weeks, 22.2%; 24 weeks, 34.9% |
| Beerman et al. 25 | 99.3 (17.7) kg | 3 months: pre‐drug diet weight loss < 2.5 kg, −4.8 (3.4) kg; pre‐drug diet weight loss ≥ 2.5 kg, −5.4 (4.1) (p = NS between groups) | 3 months: pre‐drug diet weight loss < 2.5 kg, −5.0%; pre‐drug diet weight loss ≥ 2.5 kg, −5.3% | 5 to < 10%: 38.4% (all patients), 40.2% (pre‐drug diet loss < 2.5 kg), 36.5% (pre‐drug diet loss ≥ 2.5 kg) at 3 months | |
| Douglas et al. 30 | NR |
1–4 months, −0.94 kg/month; 5–25 months, +0.16 kg/month; 26–36 months, +0.01 kg/month Small progressive weight increases in matched, non‐exposed controls over 3 years |
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| Gorgojo‐Martínez et al. 32 | 107.8 (19.1) kg | −3.8 kg at 3–6 months; −3.3 kg at end of follow‐up (p < 0.0001 vs. baseline both time points) | > 5%: 3–6 months, 30.7%; end of follow‐up, 27.4% | ||
| Grabarczyk 33 | 121.2 (26.2) kg | −2.2 (12.8)% at 12 weeks; −2.1 (12.7)% at ≥ 20 weeks; −2.8 (14.5)% at 36 weeks | ≥ 5%: 12 weeks, 23.5%; ≥ 20 weeks, 27.1% | ||
| Allie et al. 24 | T2DM | 116 (24.6) kg | −6.0 kg at 3–6 months (p < 0.001 vs. baseline) | −5% at 3–6 months | |
| Douglas et al. 30 | NR | 1–4 months, −0.78 kg/month; 5–25 months, +0.10 kg/month; 26–36 months, −0.03 kg/month | |||
| Graham et al. 34 | ORL + WL clinic, 134.5 (23.6) kg; ORL alone, 152 (28) kg | 6 months: ORL + WL clinic, −5.0 (6.0) kg (p = 0.005 vs. baseline); ORL alone, −2.2 (4.7) kg (p = 0.027 vs. baseline) (p = NS between groups) | ≥ 5%: 28% (ORL + WL clinic), 14% (ORL alone) at 6 months (p = NS between groups) | ||
| Douglas et al. 30 | CVD b | NR | 1–4 months, −0.97 kg/month; 5–25 months, +0.13 kg/month; 26–36 months, 0.00 kg/month | ||
| Horie et al. 38 | ≥ 60 years | 96.2 (15.78) kg | −3.30 (5.86) kg at 9 months | ||
| PHENTERMINE: PROSPECTIVE COHORTS | |||||
| Kim et al. 15 | General obesity | Men, 94.2 (18.3) kg; Women, 67.8 (11.6) kg | −3.8 (4.0) kg at 12 weeks | −5.2% at 12 weeks | ≥ 5%: 12 weeks, 45.6% |
| PHENTERMINE: RETROSPECTIVE COHORTS | |||||
| Costello et al. 26 | General obesity | Median (range), 109.5 (75.9–156.6) kg | Median (range), −4.2 (−13.9 to 5.5) kg at 12 weeks | Median −4.9% at 12 weeks | ≥ 5%: 12 weeks, 50% |
| Grabarczyk 33 | 121.5 (29) kg |
−2.1 (14.2)% at 12 weeks; −3.6 (11.9)% at ≥ 20 weeks; −2.5 (14.4)% at 36 weeks |
≥ 5%: 12 weeks, 30.5%; ≥ 20 weeks, 38.5% | ||
| Hendricks et al. 36 | PHEN + WL program, 98.4 (24.5) kg; WL program, 102.7 (19.8) kg |
12 weeks: PHEN + WL program, −15.1 (4.0)% vs. WL program, −12.8 (3.9)% 26 weeks: −18.9 (6.5)% vs. − 17.4 (6.0)% 52 weeks: −17.6 (7.8)% vs. − 16.1 (9.7)% 104 weeks: −12.7 (8.2)% vs. − 8.4 (10.7)% (p = 0.0144 between groups) |
≥ 5%: 97% (PHEN), 80% (WL program only) at 52 weeks | ||
| Lewis et al. 40 | NR |
6 months: short‐term use, −2.7%; medium‐term use,−7.7% c 12 months: −1.4%; −6.0% 24 months: −0.2%; −1.9%; long‐term use, −7.5% c |
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| Li et al. 41 | Men, 124.9 (SEM, 28.2) kg; Women, 103.4 (24.0) kg |
−7.6 (4.4) kg (men), −6.3 (3.4) kg (women) at 8 weeks −9.7 (5.3) kg (men), −8.0 (6.5) kg (women) at 12 weeks |
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| Shibuya et al. 47 | 104.7 (24.8) kg | −3.87 (5.9) kg at 12 weeks (p < 0.0001 vs. baseline) | −3.75% at 12 weeks | ≥ 5%: 12 weeks, 39% | |
| Elhag et al. 49 | Surgical | Surgical, 94.8 (18.2) kg; Non‐surgical, 100.2 (20.9) kg | 3 months: surgical, −7.68 (10.32) kg (−7.62%); non‐surgical, −8.42 (9.69) kg (−7.65%) | 3 months: surgical, −7.62%; non‐surgical, −7.65% | 5–9.9%: 21.1% (surgical), 20.8% (non‐surgical) at 3 months |
| Schwartz et al. 52 | 111.1 (25.4) kg | −6.3 kg at 90 days | −12.8% at 90 days | ||
| Toth et al. 53 | Surgical; 21–30 years | NR | Median −7.7% at nadir weight | ||
| Shibuya et al. 47 | T2DM b | NR | 3 months: T2DM, −3.30 (7.49) kg; non‐T2DM, −3.99 (5.67) kg (p = 0.21 vs. T2DM) | ||
| PHENTERMINE/TOPIRAMATE: RETROSPECTIVE COHORTS | |||||
| Costello et al. 26 | General obesity | Median (range), 115.5 (75.8 to 134.5) kg | −2.2 kg (−16.8 to 0.1 kg) at 12 weeks | −2.8% at 12 weeks | |
| Grabarczyk 33 | 124.7 (29.5) kg | −3.4 (14.2)% at 12 weeks; −4.1 (12.6)% at ≥ 20 weeks; −4.3 (14.1)% at 36 weeks | ≥ 5%: 12 weeks, 34.1%; ≥ 20 weeks, 40.3% | ||
| Neoh et al. 42 | 122.5 (29.7) kg (post‐VLED, pre‐drug) |
−7.4 kg at nadir weight (p = 0.01 vs. post‐VLED, pre‐drug) −4.8 kg at final weight (p = 0.01 vs. post‐VLED, pre‐drug) |
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| Shibuya et al. 47 | 104.1 (22.8) kg | −3.76 (5.6) kg at 12 weeks (p < 0.0001 vs. baseline) | −3.63% at 12 weeks | ≥ 5% loss: 12 weeks, 36.7% | |
| Schwartz et al. 52 | Surgical | 105.8 (22.8) kg | −3.8 kg (−12.9%) at 90 days | −12.9% at 90 days | |
| Shibuya et al. 47 | T2DM b | NR | 3 months: T2DM, −3.40 (5.72) kg; non‐T2DM, −3.88 (5.23) kg (p = 0.72 vs. T2DM) | ||
| LIRAGLUTIDE: PROSPECTIVE COHORTS | |||||
| Suliman et al. 19 | General obesity | 97.9 kg | −6.0 kg (95% CI 2.4, 9.4) at ≥ 16 weeks; −7.4 kg (−3.5, −11.0) at ≥ 28 weeks | −6.4% at ≥ 16 weeks; −7.6% at ≥ 28 weeks | |
| Suliman et al. 19 | Surgical | NR |
≥ 16 weeks: surgical, −6.4%; non‐surgical, −6.1% (p < 0.0001 vs. baseline both groups) RYGB vs. SG at ≥ 28 weeks, −5.6% vs. − 3.3% (p = 0.025) |
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| Wharton et al. 20 | NR | 7.6 months (mean follow‐up): all patients, −6.3 (7.7) kg; RYGB, −7.1 (8.7) kg; gastric band, −6.0 (7.2) kg; SG, −4.5 (4.5) kg (p < 0.05 vs. baseline, all groups) | 7.6 months (mean follow‐up): all patients, −5.5%; RYGB, −6.6%; gastric band, −4.9%; SG, −3.6% | ||
| LIRAGLUTIDE: RETROSPECTIVE COHORTS | |||||
| Gorgojo‐Martínez et al. 32 | General obesity | 105.1 (18.6) kg | −6.4 kg (95% CI −7.5, −5.3) at 3–6 months; −7.7 kg (−9.0, −6.3) at end of follow‐up (p < 0.0001 vs. baseline, both time points) | > 5%: 3–6 months, 56.5%; end of follow‐up, 64.7% | |
| Wharton et al. 48 | All, 115.5 (28.4) kg; ≥ 6 months persistent, 117.6 (31) kg; ≥ 4 months persistent, 115.9 (28.8) kg | 6 months: all patients, −7.3 kg; ≥ 6 months persistent, −8.0 kg; ≥ 4 months persistent, −7.0 kg (p < 0.001 vs. baseline, all groups) | 6 months: all patients, −6.5%; ≥ 6 months persistent, −7.1%; ≥ 4 months persistent, −6.3% | ≥ 5%: 58.6% (all patients), 64.1% ( ≥ 6 months persistent), and 63.1% ( ≥ 4 months persistent) at 6 months | |
| Rye et al. 51 | Surgical | NR | Median −7.1% (IQR, −5.1 to −12.2%) at 16 weeks; −9.7% (−7.8 to −13.9%) at 28 weeks | ||
| Rye et al. 51 | Surgical, T2DM (n = 5) b | NR | Median −5.7% (IQR, −4.9 to −8.5%) at 16 weeks; −8.4% (−7.7 to −9.1%) at 28 weeks | ||
| NALTREXONE/BUPROPION: RETROSPECTIVE COHORTS | |||||
| Shibuya et al. 47 | General obesity | 110.5 (26.6) kg | −2.9 (5.5) kg (−2.66%) at 12 weeks (p < 0.0001 vs. baseline) | −2.66% at 12 weeks | ≥ 5%: 12 weeks, 29.2% |
| Shibuya et al. 47 | T2DM b | NR | 3 months: T2DM, −4.79 (4.92) kg; non‐T2DM, −2.16 (4.76) kg (p = 0.05 vs. T2DM) | ||
| POOLED AOMs: RETROSPECTIVE COHORTS | |||||
| Nor Hanipah et al. 50 |
Surgical Pooled: PHEN, PHEN/TPM, LORC, NTX/BPN |
RYBG, 100.5 kg; LAGB, 106.5 kg; SG, 101.2 kg |
3 months: all patients, −3.2 kg; RYGB, −3.2 kg; SG, −2.4 kg; LAGB, −4.5 kg 12 months: all patients, −2.4 kg; RYGB, −3.2 kg; SG, −0.3 kg; LAGB, −4.6 kg |
3 months: all patients, −3.2%; RYGB, −3.2%; SG, −2.5%; LAGB, −4.6% 12 months: all patients, −2.2%; RYGB, −2.8% (p = 0.02 vs. SG); SG, −0.3%; LAGB, −4.6% (p = 0.01 vs. SG) |
> 5%, 3 months: 30.0% (all patients), 31.1% (RYGB), 20.8% (SG), and 42.1% (LAGB) > 5%, 12 months: 36.9% (all patients), 40.0% (RYGB; p = 0.03 vs. SG), 21.4% (SG), and 58.8% (LAGB; p = 0.005 vs. SG) |
Abbreviations: AOM, anti‐obesity medication; BPN, bupropion; CI, confidence interval; CVD, cardiovascular disease; DM, diabetes mellitus; IQR, interquartile range; LAGB, laparoscopic‐adjustable gastric band; LIRA, liraglutide; LORC, lorcaserin; NR, not reported; NS, not statistically significant; NTX, naltrexone; ORL, orlistat; PHEN, phentermine; RYGB, Roux‐en‐Y gastric bypass; SG, sleeve gastrectomy; T2DM, type 2 diabetes mellitus; TPM, topiramate; VLED, very‐low energy diet; WL, weight loss.
All comparisons are versus baseline (pre‐drug) and values are mean (SD) unless otherwise stated.
Subgroup of the overall study population; CVD subgroup not explicitly described, but assumed to include patients with cerebrovascular disease, coronary heart disease, and hypertension.
Short‐term use defined as phentermine for < 112 days and no subsequent use (referent group); medium‐term continuous use defined as phentermine for > 112 days up to 365 days, but no subsequent use; long‐term use defined as phentermine for > 112 days and > 365 days. Patients could move between categories (i.e., a medium‐term continuous user could become a long‐term user over time).
Including five eligible for this review (PHEN, NTX/BPN, ORL, LIRA, and PHEN/TPM).