{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:43:43Z","timestamp":1788871423773,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,5,22]],"date-time":"2015-05-22T00:00:00Z","timestamp":1432252800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000833","name":"Rosetrees Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000833","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"NIHR","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Drug treatments for obesity have proven efficacy from randomized trials, but their effectiveness in routine clinical practice is unknown. We assessed the effects on weight and body mass index (BMI) of orlistat and sibutramine when delivered in routine primary care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used United Kingdom data from the Clinical Practice Research Datalink to estimate the effects of orlistat or sibutramine on weight and BMI over 3\u2009years following treatment initiation. For comparison, we matched each patient with up to five obese patients receiving neither drug. Mixed effects linear regression with splines was used to model change in weight and BMI. Mean change with 95% confidence intervals (CI) was estimated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified 100 701 patients receiving orlistat, 15 355 receiving sibutramine and 508 140 non\u2010intervention patients, with body mass index of 37.2, 36.6 and 33.2\u2009kg\u2009m\n                      <jats:sup>\u22122<\/jats:sup>\n                      , respectively. Patients receiving orlistat lost, on average, 0.94\u2009kg\u2009month\n                      <jats:sup>\u22121<\/jats:sup>\n                      (0.93 to 0.95) over the first 4\u2009months. Weight gain then occurred, although weight remained slightly below baseline at 3\u2009years. Patients receiving sibutramine lost, 1.28\u2009kg\u2009month\n                      <jats:sup>\u22121<\/jats:sup>\n                      (1.26 to 1.30) over the first 4\u2009months, but by 3\u2009years had exceeded baseline weight. Non\u2010intervention patients had slight increases in weight throughout the 3\u2009year period, with gains ranging between 0.01 and 0.06\u2009kg\u2009month\n                      <jats:sup>\u22121<\/jats:sup>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Orlistat and sibutramine had early effects on weight loss, not sustained over 3\u2009years. As new treatments for obesity are approved, their effectiveness should be measured in routine clinical practice, as effectiveness may be considerably less than seen in randomized trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bcp.12578","type":"journal-article","created":{"date-parts":[[2014,12,31]],"date-time":"2014-12-31T01:16:27Z","timestamp":1419988587000},"page":"1020-1027","source":"Crossref","is-referenced-by-count":24,"title":["The effectiveness of pharmaceutical interventions for obesity: weight loss with orlistat and sibutramine in a United Kingdom population\u2010based cohort"],"prefix":"10.1111","volume":"79","author":[{"given":"Ian J.","family":"Douglas","sequence":"first","affiliation":[{"name":"Epidemiology Population Health London School of Hygiene Tropical Medicine  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishnan","family":"Bhaskaran","sequence":"additional","affiliation":[{"name":"Epidemiology Population Health London School of Hygiene Tropical Medicine  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel L.","family":"Batterham","sequence":"additional","affiliation":[{"name":"Centre for Obesity Research, Rayne Institute Department of Medicine University College London  London United Kingdom"},{"name":"UCLH Centre for Weight Loss Metabolic and Endocrine Surgery University College London Hospitals  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liam","family":"Smeeth","sequence":"additional","affiliation":[{"name":"Epidemiology Population Health London School of Hygiene Tropical Medicine  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,5,22]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Department of Health.Obesity general information 2011.2011. Available athttp:\/\/webarchive.nationalarchives.gov.uk\/+\/www.dh.gov.uk\/en\/Publichealth\/Obesity\/DH_078098(last accessed 4 October 2013)."},{"key":"e_1_2_10_3_1","unstructured":"WHO.Obesity and overweight. Fact sheet no. 311 updated March 2013.2013. Available athttp:\/\/www.who.int\/mediacentre\/factsheets\/fs311\/en\/index.html(last accessed 5 November 2013)."},{"key":"e_1_2_10_4_1","unstructured":"European Medicines Agency.Questions and answers on the refusal of the marketing authorisation for Qsiva (phentermine\/topiramate EMA\/109958\/2013 EMEA\/H\/C\/002350.2013. Available athttp:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/Summary_of_opinion_\u2010_Initial_authorisation\/human\/002350\/WC500139215.pdf(last accessed 8 November 2013)."},{"key":"e_1_2_10_5_1","unstructured":"European Medicines Agency.Questions and answers on the withdrawal of the marketing authorisation application for Belviq (lorcaserin) EMA\/309180\/2013 EMEA\/H\/C\/002597.2013. Available athttp:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/Medicine_QA\/2013\/05\/WC500143811.pdf(last accessed 8 November 2013)."},{"key":"e_1_2_10_6_1","unstructured":"National Institute for Health and Clinical Excellence.Obesity: the prevention identification assessment and management of overweight and obesity in adults and children. CG43 2006. Available athttp:\/\/guidance.nice.org.uk\/CG43(last accessed 4 October 2013)."},{"key":"e_1_2_10_7_1","unstructured":"NHLBI Obesity Education Initiative Expert Panel on the Identification Evaluation and Treatment of Obesity in Adults (US).Clinical Guidelines on the Identification Evaluation and Treatment of Overweight and Obesity in Adults: The Evidence Report.Bethesda MD:National Heart Lung and Blood Institute 1998. 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