Research Article
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Effect of Orlistat Treatment on Visceral Adiposity Index (VAI) in Obese Patients

Year 2025, Volume: 15 Issue: 2, 128 - 134, 30.06.2025
https://doi.org/10.31832/smj.1648000

Abstract

Introduction: Obesity is a chronic disease characterized by excessive fat accumulation. This study aims to assess the impact of orlistat treatment on the visceral adiposity index and related parameters.
Material and Method: This study involved 54 patients (18–65 years, BMI >25) from the internal medicine and obesity clinic. Ethical approval and informed consent were obtained. Patients receiving orlistat were monitored at 0, 3, and 6 months. Anthropometric measurements (BMI, weight, waist, and hip circumference) and biochemical markers (glucose, AST, ALT, GGT, TG, HDL) were recorded. VAI was calculated separately for males and females.
Results: Clinical and biochemical parameters of 54 patients (F: 52, M: 2) were analyzed. At baseline, mean body weight (103.87±13,01 kg), waist circumference (113.59±10.25 cm), and BMI (41.59±4.86) indicated obesity. Liver enzymes (AST: 20.13 U/L, ALT: 21.87 U/L, GGT: 24.76 U/L) were mostly normal, with slight GGT elevations. Lipid profile showed mean HDL (47.11 mmol/L) and triglycerides (154,89 mg/dL). Over 6 months, significant reductions were observed in weight (93.33±12,44 kg, p<0.01), BMI (37.47±4.61, p<0.01), and waist circumference (105.9±10.2 cm, p<0.01). ALT (p<0.01) and GGT (p<0.001) decreased significantly, while AST did not (p=0.159). HDL improved (p<0.016). VAI slightly decreased (4.42±2.76 to 4.01±2.84), but was not statistically significant (p=0.224). These results suggest weight loss benefits metabolic and liver health.
Conclusion: The study observed positive metabolic changes, including weight loss, reduced waist circumference, and decreased BMI. Although VAI showed a decreasing trend after orlistat treatment, the change was not statistically significant. These findings indicate the potential benefits of orlistat.

Ethical Statement

The study protocol was approved by the local ethics committee of Diyarbakır Health Sciences University Gazi Yaşargil Training and Research Hospital (321/17.01.2025) and approval and local institutional approvals were obtained for the study.

References

  • Chu H, Kang B, Youn B, et al. Comprehensive traditional East Asian medicine treatment strategy for obesity considering the therapeutic effects and adverse events. Medicine (Baltimore). 2022;101(6):e28673.
  • Wirth A, Wabitsch M, Hauner H. The prevention and treatment of obesity. Dtsch Arztebl Int. 2014;111(42):705-713. doi:10.3238/arztebl.2014.0705
  • Türkiye Endokrinoloji ve Metabolizma Derneği (TEMD). Obezite Tanı ve Tedavi Kılavuzu. Ankara: BAYT Grafik Tasarım ve Yayın Hizmetleri; 2024.
  • World Health Organization. Obesity and overweight. Accessed October 2, 2024. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
  • Heck AM, Yanovski JA, Calis KA. Orlistat, a new lipase inhibitor for the management of obesity. Pharmacotherapy. 2000;20:270–279.
  • Amato MC, Giordano C. Visceral adiposity index: An indicator of adipose tissue dysfunction. Int J Endocrinol. 2014;2014:730827. doi:10.1155/2014/730827
  • Nusrianto R, Ayundini G, Kristanti M, Astrella C, Amalina N, Muhadi, et al. Visceral adiposity index and lipid accumulation product as a predictor of type 2 diabetes mellitus: The Bogor cohort study of non-communicable diseases risk factors. Diabetes Res Clin Pract. 2019;155:107798. doi:10.1016/j.diabres.2019.107798
  • Amato MC, Giordano C, Galia M, Criscimanna A, Vitabile S, Midiri M, et al. AlkaMeSy Study Group. Visceral Adiposity Index: A reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care. 2010;33(4):920-922. doi:10.2337/dc09-1825
  • Filippatos TD, Derdemezis CS, Gazi IF, Nakou ES, Mikhailidis DP, Elisaf MS. Orlistat-associated adverse effects and drug interactions: A critical review. Drug Saf. 2008;31:53–65. doi:10.2165/00002018-200831010-00005
  • Lacey LA, Wolf A, O’shea D, Erny S, Ruof J. Cost-effectiveness of orlistat for the treatment of overweight and obese patients in Ireland. Int J Obes (Lond). 2005;29:975–982. doi:10.1038/sj.ijo.0802947
  • Al-Kuraishy HM, Al-Gareeb AI. Effect of orlistat alone or in combination with Garcinia cambogia on visceral adiposity index in obese patients. J Intercult Ethnopharmacol. 2016;5(4):408-414. doi:10.5455/jice.20160815080732
  • Zelber-Sagi S, Kessler A, Brazowsky E, et al. A double-blind randomized placebo-controlled trial of orlistat for the treatment of nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol. 2006;4(5):639-644. doi:10.1016/j.cgh.2006.02.004
  • Xu Q, Higgins T, Cembrowski GS. Limiting the testing of AST: A diagnostically nonspecific enzyme. Am J Clin Pathol. 2015;144(3):423-426. doi:10.1309/AJCPO47VAWYRIDHG
  • McMillan KP, Kuk JL, Church TS, Blair SN, Ross R. Independent associations between liver fat, visceral adipose tissue, and metabolic risk factors in men. Appl Physiol Nutr Metab. 2007;32(2):265-72. doi:10.1139/h06-112
  • Smith SR, Stenlof KS, Greenway FL, et al. Orlistat 60 mg reduces visceral adipose tissue: A 24-week randomized, placebo-controlled, multicenter trial. Obesity (Silver Spring). 2011;19(9):1796-1803. doi:10.1038/oby.2011.143

Year 2025, Volume: 15 Issue: 2, 128 - 134, 30.06.2025
https://doi.org/10.31832/smj.1648000

Abstract

References

  • Chu H, Kang B, Youn B, et al. Comprehensive traditional East Asian medicine treatment strategy for obesity considering the therapeutic effects and adverse events. Medicine (Baltimore). 2022;101(6):e28673.
  • Wirth A, Wabitsch M, Hauner H. The prevention and treatment of obesity. Dtsch Arztebl Int. 2014;111(42):705-713. doi:10.3238/arztebl.2014.0705
  • Türkiye Endokrinoloji ve Metabolizma Derneği (TEMD). Obezite Tanı ve Tedavi Kılavuzu. Ankara: BAYT Grafik Tasarım ve Yayın Hizmetleri; 2024.
  • World Health Organization. Obesity and overweight. Accessed October 2, 2024. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
  • Heck AM, Yanovski JA, Calis KA. Orlistat, a new lipase inhibitor for the management of obesity. Pharmacotherapy. 2000;20:270–279.
  • Amato MC, Giordano C. Visceral adiposity index: An indicator of adipose tissue dysfunction. Int J Endocrinol. 2014;2014:730827. doi:10.1155/2014/730827
  • Nusrianto R, Ayundini G, Kristanti M, Astrella C, Amalina N, Muhadi, et al. Visceral adiposity index and lipid accumulation product as a predictor of type 2 diabetes mellitus: The Bogor cohort study of non-communicable diseases risk factors. Diabetes Res Clin Pract. 2019;155:107798. doi:10.1016/j.diabres.2019.107798
  • Amato MC, Giordano C, Galia M, Criscimanna A, Vitabile S, Midiri M, et al. AlkaMeSy Study Group. Visceral Adiposity Index: A reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care. 2010;33(4):920-922. doi:10.2337/dc09-1825
  • Filippatos TD, Derdemezis CS, Gazi IF, Nakou ES, Mikhailidis DP, Elisaf MS. Orlistat-associated adverse effects and drug interactions: A critical review. Drug Saf. 2008;31:53–65. doi:10.2165/00002018-200831010-00005
  • Lacey LA, Wolf A, O’shea D, Erny S, Ruof J. Cost-effectiveness of orlistat for the treatment of overweight and obese patients in Ireland. Int J Obes (Lond). 2005;29:975–982. doi:10.1038/sj.ijo.0802947
  • Al-Kuraishy HM, Al-Gareeb AI. Effect of orlistat alone or in combination with Garcinia cambogia on visceral adiposity index in obese patients. J Intercult Ethnopharmacol. 2016;5(4):408-414. doi:10.5455/jice.20160815080732
  • Zelber-Sagi S, Kessler A, Brazowsky E, et al. A double-blind randomized placebo-controlled trial of orlistat for the treatment of nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol. 2006;4(5):639-644. doi:10.1016/j.cgh.2006.02.004
  • Xu Q, Higgins T, Cembrowski GS. Limiting the testing of AST: A diagnostically nonspecific enzyme. Am J Clin Pathol. 2015;144(3):423-426. doi:10.1309/AJCPO47VAWYRIDHG
  • McMillan KP, Kuk JL, Church TS, Blair SN, Ross R. Independent associations between liver fat, visceral adipose tissue, and metabolic risk factors in men. Appl Physiol Nutr Metab. 2007;32(2):265-72. doi:10.1139/h06-112
  • Smith SR, Stenlof KS, Greenway FL, et al. Orlistat 60 mg reduces visceral adipose tissue: A 24-week randomized, placebo-controlled, multicenter trial. Obesity (Silver Spring). 2011;19(9):1796-1803. doi:10.1038/oby.2011.143
There are 15 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Research Article
Authors

İhsan Solmaz 0000-0002-6624-8063

Jehat Kılıç 0000-0003-3722-350X

Ömer Faruk Alakuş 0000-0003-4039-1256

Early Pub Date June 12, 2025
Publication Date June 30, 2025
Submission Date February 27, 2025
Acceptance Date April 17, 2025
Published in Issue Year 2025 Volume: 15 Issue: 2

Cite

AMA Solmaz İ, Kılıç J, Alakuş ÖF. Effect of Orlistat Treatment on Visceral Adiposity Index (VAI) in Obese Patients. Sakarya Tıp Dergisi. June 2025;15(2):128-134. doi:10.31832/smj.1648000

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