Does metabolic syndrome mitigate weight loss in overweight Mexican American women treated for 1-year with orlistat and lifestyle modification?

  • Megan M. Pinkston
  • W. S. C. Poston
  • R. S. Reeves
  • C. K. Haddock
  • J. E. Taylor
  • J. P. Foreyt
Brief Report


Aims To investigate the effects of a pharmacotherapy (orlistat) plus lifestyle management (OLM) intervention on weight loss in Mexican American women with and without metabolic syndrome (MS). Methods: One hundred and seven female participants aged 21–65 years and of Mexican origin were randomized to either OLM or a wait-list control group (WLC) for one year. The lifestyle interventions were tailored to exhibit features of the Mexican culture. Within each group, subjects with MS were compared to those without MS to assess whether its presence mitigates weight loss. Risk factors for MS also were assessed. Results: Participants with MS in the OLM group experienced significant decreases in weight and body mass index (BMI) as compared to participants without MS. Participants with MS in the OLM group and who completed the study lost 9.3±7.5 kg (20.5±16.5 lb) as compared to participants with MS in the WLC group, who only lost 0.2±3.1 kg (0.4±6.8 lb). Further, participants with MS in the OLM group who completed the study experienced a 3.1±3.9 kg/m2 decrease in BMI whereas participants with MS in the WLC group only experienced a 0.1±1.2 kg/m2 decrease in BMI. No changes in other MS risk factors were significant. Conclusions: Patients with MS experienced significant weight loss and decreases in BMI as a result of a lifestyle and pharmacotherapy intervention.

Key words

Metabolic syndrome orlistat obesity insulin resistance weight loss 


  1. 1.
    Fontaine K.R., Redden D.T., Wang C., Westfall A.O., Allison D.B.: Years of life lost due to obesity. JAMA, 289, 187–193, 2003.PubMedCrossRefGoogle Scholar
  2. 2.
    Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults: Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA, 285, 2486–2497, 2001.CrossRefGoogle Scholar
  3. 3.
    Ford E.S., Giles W.H., Dietz W.H.: Prevalence of the metabolic syndrome among US adults. Findings from the third national health and nutrition examination survey. JAMA, 287, 356–359, 2002.PubMedCrossRefGoogle Scholar
  4. 4.
    National Institutes of Health: Physical Activity and Cardiovascular Health. NIH Consensus Statement, 13, 1–33, 1995.Google Scholar
  5. 5.
    Knowler W.C., Barrett-Connor E., Fowler S.E., Hamman R.F., Lachin J.M., Walker E.A., Nathan D.M.: Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N. Engl. J. Med., 346, 393–403, 2002.PubMedCrossRefGoogle Scholar
  6. 6.
    Phelan S., Wadden T.A.: Combining behavioral and pharmacological treatments for obesity. Obes. Res., 10, 560–574, 2002.PubMedCrossRefGoogle Scholar
  7. 7.
    Poppitt S.D., Keogh G.F., Prentice A.M., Williams D.E., Sonnemans H.M., Valk E.E., Robinson E., Wareham N.J.: Long-term effects of ad libitum low-fat, high-carbohydrate diets on body weight and serum lipids in overweight subjects with metabolic syndrome. Am. J. Clin. Nutr., 75, 11–20, 2002.PubMedGoogle Scholar
  8. 8.
    Metabolic Syndrome by the American Heart Association. (2002). Retrieved February 4, 2004, from
  9. 9.
    Minehira K., Tappy L.: Dietary and lifestyle interventions in the management of the metabolic syndrome: Present status and future perspective. Eur. J. Clin. Nutr., 56, 1264–1269, 2002.CrossRefGoogle Scholar
  10. 10.
    Fujioka K., Pirner M.A., Hewkin A., Renz C.L.: Effects of sibutramine-induced weight loss on patients with metabolic syndrome. Obes. Res., 11, A110, 2003.Google Scholar
  11. 11.
    Widén E., Eriksson J., Groop L.: Metformin normalizes nonoxidative glucose metabolism in insulin-resistant normoglycemic first-degree relatives of patients with NIDDM. Diabetes, 41, 354–358, 1992.PubMedCrossRefGoogle Scholar
  12. 12.
    Gugliano D., De Rosa N., Di Maro G., Marfella R., Acampora R., Buoninconti R., D’Onofrio F.: Metformin improves glucose, lipid metabolism, and reduces blood pressure in hypertensive, obese women. Diabetes Care, 16, 1387–1390, 1993.CrossRefGoogle Scholar
  13. 13.
    Landin K., Tengborn L.U.: Treating insulin resistance in hypertension with metformin reduces both blood pressure and metabolic risk factors. J. Intern. Med., 229, 181–187, 1991.PubMedCrossRefGoogle Scholar
  14. 14.
    Nagi D., Yudkin J.: Effect of metformin on insulin resistance, risk factors for cardiovascular disease, and plasminogen activator inhibitor in NIDDM subjects. Diabetes Care, 16, 621–629, 1993.PubMedCrossRefGoogle Scholar
  15. 15.
    Carlsen S., Rossvoll O., Bjerve K., Fölling I.: Metformin improves blood lipid pattern in nondiabetic patients with coronary heart disease. J. Intern. Med., 239, 227–233, 1996.PubMedCrossRefGoogle Scholar
  16. 16.
    Lehtovirta M., Forsén B., Gullström M., Häggblom M., Eriksson J.G., Taskinen M.-R., Groop L.: Metabolic effects of metformin in patients with impaired glucose tolerance. Diabet. Med., 18, 578–583, 2001.PubMedCrossRefGoogle Scholar
  17. 17.
    Gokcel A., Gumurdulu Y., Karakose H., Ertorer E.M., Tanaci N., Tutuncu, N.B., Guvener N.: Evaluation of the safety and efficacy of sibutramine, orlistat and metformin in the treatment of obesity. Diabetes Obes. Metab., 4, 49–55, 2002.PubMedCrossRefGoogle Scholar
  18. 18.
    Davidson M., Hauptman J., DiGirolamo M., Foreyt J.P., Halsted C.H., Herber D., Heimburger D.C., Lucas C.P., Robbins D.C., Chung J., Heymsfield S.B.: Weight control and risk factor reduction obese subjects treated for 2 years with orlistat: A randomized controlled trial. JAMA, 281, 235–242, 1999.PubMedCrossRefGoogle Scholar
  19. 19.
    Leung W.Y.S., Thomas G.N., Chan J.C.N., Tomlinson B.: Weight management and current options in pharmacotherapy: Orlistat and sibutramine. Clin. Ther., 25, 58–80, 2003.PubMedCrossRefGoogle Scholar
  20. 20.
    Sjostrom L., Rissanen A., Andersen T., Boldrin M., Golay A., Koppeschaar H.P., Krempf M. for the European Multicenter Orlistat Study Group. Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients. Lancet, 352, 167–172, 1998.PubMedCrossRefGoogle Scholar
  21. 21.
    Finer N., James W.P., Kopelman P.G., Lean M.E.: Williams G.: One-year treatment of obesity: A randomized, double-blind, placebo-controlled, multicenter study of orlistat, a gastrointestinal lipase inhibitor. Int. J. Obes. Relat. Metab. Disord., 24, 306–313, 2000.PubMedCrossRefGoogle Scholar
  22. 22.
    Torgerson J.S., Boldrin M.N., Hauptman J., Sjostrom L.: Xenical in the prevention of diabetes in obese subjects (XENDOS) study. Diabetes Care, 27, 155–161, 2004.PubMedCrossRefGoogle Scholar
  23. 23.
    Poston W.S.C., Reeves R.S., Haddock C.K., Stormer S., Balasubramanyam A., Satterwhite O., Taylor J.E., Foreyt J.P.: Weight loss in obese Mexican Americans treated for 1-year with orlistat and lifestyle modification. Int. J. Obes. Relat. Metab. Disord., 27, 1486–1493, 2003.PubMedCrossRefGoogle Scholar
  24. 24.
    Foreyt J.P., Ramirez A.G., Cousins J.H.: Cuidando El Corazon — a weight reduction intervention for Mexican American women. Am. J. Clin. Nutr., 53, 1639S–1641S, 1991.PubMedGoogle Scholar
  25. 25.
    Jeppesen J., Hein H.O., Suadicani P., Gyntelberg F.: Low triglycerides-high high-density lipoprotein cholesterol and risk of ischemic heart disease. Arch. Intern. Med., 161, 361–366, 2001.PubMedCrossRefGoogle Scholar
  26. 26.
    Case C.C., Jones P.H., Nelson K., O’Brian Smith E., Ballantyne C.M.: Impact of weight loss on the metabolic syndrome. Diabetes Obes. Metab., 4, 407–414, 2002.PubMedCrossRefGoogle Scholar
  27. 27.
    Reaven G.M.: Insulin resistance/compensatory hyperinsulinemia, essential hypertension, and cardiovascular disease. J. Clin. Endocrinol. Metab., 88, 2399–2403, 2003.PubMedCrossRefGoogle Scholar
  28. 28.
    McLaughlin T., Abbasi F., Cheal K., Chu J., Lamendola C., Reaven G.: Use of metabolic factors to identify overweight individuals who are insulin resistant. Ann. Intern. Med., 139, 802–809, 2003.PubMedCrossRefGoogle Scholar

Copyright information

© Editrice Kurtis 2006

Authors and Affiliations

  • Megan M. Pinkston
    • 1
  • W. S. C. Poston
    • 1
  • R. S. Reeves
    • 2
  • C. K. Haddock
    • 1
  • J. E. Taylor
    • 1
  • J. P. Foreyt
    • 2
  1. 1.Mid America Heart InstituteUniversity of Missouri-Kansas CityKansas CityUSA
  2. 2.Baylor College of MedicineHoustonUSA

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