XENICAL Professional - Health Risks of Obesity: Multiple Risks


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	> Hypertension
	> Dyslipidemia
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The increasing prevalence of overweight and obesity in the United States and the corresponding incidence of obesity-related comorbidities underscore the need for preventing and treating the condition of obesity rather than focusing solely on its associated health risks.³⁹

As we know from the literature, obesity is closely associated with the increasing risk of a number of complications that can occur alone or concomitantly. These include hypertension, dyslipidemia, cardiovascular disease, stroke, type 2 diabetes, gallbladder disease, respiratory dysfunction, gout and osteoarthritis. And there are still others — certain cancers, for example.⁴¹

Multiple Risk Factors and Obesity

Chronic diseases, such as type 2 diabetes, hypertension and hypercholesterolemia, are frequent consequences of obesity. Data from the National Center for Health Statistics' Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994) show that 65% of overweight and obese adults (BMI >27) have at least one of these chronic diseases, and 27% have two or more.¹⁶

Pie chart showing Sixty-five percent of obese patients have type 2 diabetes, and/or hypertension and/or hypercholesterolemia

The following chart shows that as BMI increased so did the prevalence of type 2 diabetes, hypertension and hypercholesterolemia. Further, the impact of these obesity-related comorbidities grows as patients gain weight; the risk of occurrence, prevalence and severity of these comorbidities are, in general, positively correlated with BMI.^39,54,70 Epidemiological studies have found a curvilinear relationship between body weight and increasing risk of both mortality and morbidity. In fact, comorbid chronic disease is the major risk.¹³

Graph showing how Comorbidities Increase with Increasing BMI

Type 2 Diabetes and treatment with XENICAL

In a study of patients with type 2 diabetes stabilized on sulfonylureas, 30% of the patients treated with XENICAL achieved at least a 5% or greater reduction in body weight after one year of treatment compared to 13% of the placebo treated patients. The XENICAL plus sulfonylurea treated patients also achieved significant reductions in sulfonylurea usage and dose reduction as well as significant reductions in HbA1c and fasting glucose compared to the placebo plus sulfonylurea treatment group. In addition, treatment with XENICAL plus sulfonylurea was associated with significant reductions in total cholesterol, LDL-cholesterol, LDL/HDL ratio and triglycerides compared to placebo plus sulfonylurea treatment group.

Weight Loss with XENICAL Plus Diet: Improved Lipid Levels, Fasting Insulin and Blood Pressure

The changes from randomization following 1-year treatment in the population with abnormal lipid levels (LDL >130 mg/dL, LDL/HDL >3.5, HDL <35 mg/dL) were greater for patients on XENICAL plus diet compared to patients on placebo plus diet with respect to LDL cholesterol (-7.83% vs. +1.14%) and the LDL/HDL ratio (-0.64 vs. 0.46). HDL cholesterol increased in the placebo group by 20.1% and in the XENICAL group by 18.8%.
In patients with abnormal baseline values of fasting insulin
(>120 pmol/L), weight loss with XENICAL plus diet resulted in a greater decrease in fasting insulin than did placebo (-39 pmol/L vs. -16 pmol/L, respectively) from randomization to 1 year.
In the population with abnormal blood pressure at baseline (systolic BP >140 mm Hg), the change in systolic blood pressure from randomization to 1 year was greater for patients on XENICAL plus diet (-10.89 mm Hg) than for patients on placebo plus diet (-5.07 mm Hg). Patients with diastolic blood pressure >90 mm Hg on XENICAL plus diet also had greater changes in diastolic blood pressure (-7.9 mm Hg) than those on placebo plus diet did (-5.5 mm Hg).

The long-term effects of XENICAL (orlistat) on morbidity and mortality associated with obesity have not been established.

Health Benefits of Weight Loss: Type 2 Diabetes

Health Benefits of Weight Loss: Hypertension

Health Benefits of Weight Loss: Dyslipidemia

Managing Patients with Obesity-Related Comorbidities