The Effect of Orlistat as an Adjuvant to Lifestyle Modification on Weight Loss in Polycystic Ovary Syndrome Patients:An Evidence-Based Case Report

Polycystic ovary syndrome (PCOS) occurs in 1 of 10 women of reproductive age. This syndrome is highly associated with obesity. Therefore, many of the patients face weight loss challenges. Given that many patients find it rather difficult to change their lifestyle, medicamentous intervention poses an option. Orlistat is an inhibitor of carboxyl ester lipase which inhibits the hydrolysis of dietary triglycerides that decreases the absorption of fatty acids and monoglyceride. The purpose of this study is to determine whether administration of orlistat can improve diet and exercise-induced body weight reduction in PCOS patients with obesity. Literature searching was done in 3 databases: PubMed, Cochrane Library, and Embase which yielded 141 articles. Findings were narrowed down using duplicate removal, inclusion and exclusion criteria into two relevant articles of randomized controlled trials. One randomized clinical trial showed a greater percentage in weight loss in PCOS patients BMI>23 kg/m2 administered with orlistat and lifestyle modification in comparison to lifestyle modification alone (7.81% (6.51–9.11%) vs 4.7% (4.19–5.21%) ; p<0.001). Similar body weight reduction was also found by another randomized clinical trial in PCOS patients BMI>25 kg/m2 with orlistat treatment (from 81.5 kg (80.3–82.7) to 76.2 kg (74.92–77.48) vs from 80.91 kg (79.65–82.17) to 79.15 kg (77.8–80.5) ; p<0.01). It was concluded that a considerable reduction of weight in obese and overweight PCOS patients was found when given orlistat with exercise and dietary interventions compared to exercise and dietary interventions alone.