Introduction: About a third of the US population and a quarter of the UK population are obese, with increased risks of hypertension, dyslipidaemia, diabetes, CVD, osteoarthritis, and some cancers. Less than 10% of overweight or obese adults aged 40-49 years revert to a normal body weight after 4 years. Nearly 5 million US adults used prescription weight-loss medication between 1996 and 1998, but a quarter of all users were not overweight.
Methods and outcomes: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of drug treatments in adults with obesity, and of bariatric surgery in adults with morbid obesity? We searched: Medline, Embase, The Cochrane Library and other important databases up to February 2007 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
Results: We found 38 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
Conclusions: In this systematic review we present information relating to the effectiveness and safety of the following interventions: orlistat, phentermine, rimonabant, sibutramine, bariatric surgery compared with medical interventions, gastric bypass, gastric banding, vertical banded gastroplasty, biliopancreatic diversion, and sleeve gastrectomy .