Authors' objectives:

The aim of this report was to evaluate weight loss drugs and anti-obesity drug treatment.

Authors' recommendations: The weight loss drugs sibutramine and orlistat are effective adjuncts to an appropriate clinical program of weight loss for obese Accident Compensation Corporation (ACC) claimants. Short-term treatment of up to six months should be considered for maximum weight loss. Longer-term treatment - i.e., up to two years should be considered if weight loss is to be maintained. Patients with uncontrolled hypertension or cardiovascular disease may not be suitable candidates for sibutramine therapy; in these patients orlistat should be considered. Meal replacement products should be considered for patients who are unable to tolerate these medications or who have not had an appropriate response. There is insufficient evidence to enable any specific product recommendations to be made. Each of these interventions should be part of a medically monitored comprehensive regimen of weight reduction based on a calorie controlled diet, behaviour modification and where possible, physical exercise and lifestyle modifications. Individuals with a body mass index (BMI) > or = 30kg/m2 are generally considered to be obese and should be considered for weight loss therapy. Claimants who have a BMI of . or = 27kg/m2 and obesity related co-morbidities including diabetes, hypertension and sleep apnoea may also benefit from medical assistance with weight loss and should be considered. Consideration should also be given to the differing recommendations for obesity thresholds in non-Caucasian populations. The World Health Organisation (WHO) has defined a lower obesity threshold (BMI > or = 25kg/m2) for use in Asian populations and a higher threshold (BMI . or = 32kg/m2) for Polynesians.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://nzhta.chmeds.ac.nz/publications.htm

Year Published: 2004

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: New Zealand

Organisation Name: New Zealand Health Technology Assessment

Contact Address: Department of Public Health and General Practice, Christchurch School of Medicine and Health Sciences, University of Otago, P.O. Box 4345, Christchurch, New Zealand. Tel: +64 3 364 1145; Fax: +64 3 364 1152;

Contact Name: nzhta@chmeds.ac.nz

Contact Email: nzhta@chmeds.ac.nz

Copyright: New Zealand Health Technology Assessment (NZHTA)