Long-term persistence with orlistat and sibutramine in a population-based cohort

Int J Obes (Lond). 2007 Oct;31(10):1567-70. doi: 10.1038/sj.ijo.0803631. Epub 2007 Apr 10.


Objective: Orlistat and sibutramine are widely prescribed antiobesity agents that are approved for 2 years of continuous use. Previous 1-4-year randomized, placebo-controlled trials of these drugs have reported average weight losses of <5 kg, significant adverse effects and attrition rates of up to 60%. The objective of this study was to determine the long-term persistence with orlistat and sibutramine therapy outside a clinical trial setting.

Design, setting and patients: Population-based administrative data from British Columbia, Canada, were used to create an inception cohort of orlistat and sibutramine users and determine the 2-year persistence with therapy.

Main outcome measure: Persistence with therapy at 2 years. Drug discontinuation was defined as the failure to refill a prescription within 120 days. Patients discontinuing therapy were censored at the 60-day mark.

Results: Nearly 17 000 users of orlistat and 3500 users of sibutramine were identified. For both orlistat and sibutramine, 1-year persistence rates were <10% and 2-year persistence rates were 2%.

Conclusion: This population-based, retrospective cohort analysis demonstrated very poor long-term persistence rates with orlistat and sibutramine and discontinuation rates that were much higher than those reported in clinical trials.

MeSH terms

  • Adult
  • Anti-Obesity Agents / therapeutic use*
  • British Columbia
  • Cyclobutanes / therapeutic use*
  • Epidemiologic Methods
  • Female
  • Humans
  • Lactones / therapeutic use*
  • Male
  • Middle Aged
  • Obesity / drug therapy*
  • Orlistat
  • Patient Compliance / statistics & numerical data*
  • Time Factors


  • Anti-Obesity Agents
  • Cyclobutanes
  • Lactones
  • Orlistat
  • sibutramine