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

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.

Keywords

• Obesity
• Orlistat
• Visceral Adiposity Index

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

1. 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.
2. 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
3. Türkiye Endokrinoloji ve Metabolizma Derneği (TEMD). Obezite Tanı ve Tedavi Kılavuzu. Ankara: BAYT Grafik Tasarım ve Yayın Hizmetleri; 2024.
4. World Health Organization. Obesity and overweight. Accessed October 2, 2024. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
5. Heck AM, Yanovski JA, Calis KA. Orlistat, a new lipase inhibitor for the management of obesity. Pharmacotherapy. 2000;20:270–279.
6. Amato MC, Giordano C. Visceral adiposity index: An indicator of adipose tissue dysfunction. Int J Endocrinol. 2014;2014:730827. doi:10.1155/2014/730827
7. 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
8. 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

9. 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
10. 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
11. 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
12. 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
13. 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
14. 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
15. 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