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The Effect of Sibutramine on Energy Expenditure and Body Composition in Obese Adolescents

Department of Methodology and Statistics (A.D.M.K.) and Human Biology, Nutrition Environment and Toxicology Research Institute Maastricht (K.R.W., W.H.M.S.), Maastricht University, 6200 MD Maastricht, The Netherlands; Department of Pediatrics (E.G.A.H.V.M., H.A.D.-v.d.W.), Subdivision of Pediatric Endocrinology, VU University Medical Center Amsterdam, 1007 MB Amsterdam, The Netherlands; and Department of Pediatrics (W.J.M.G.), University Hospital Maastricht, 6229 HX Maastricht, The Netherlands

Address all correspondence and requests for reprints to: Edgar G. A. H. Van Mil, M.D., Ph.D., Department of Pediatrics, Subdivision of Pediatric Endocrinology, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands. E-mail: e.vanmil{at}vumc.nl.

Context: Childhood obesity is now considered to be an epidemic. Drug therapy in this age group remains a topic of research.

Objective: The objective of this study was to examine the effect of treatment with sibutramine (10 mg) on body composition and energy expenditure in obese adolescents.

Design: The study was conducted as a randomized, double-blind, placebo-controlled trial.

Setting: The study was set in an obesity research center.

Patients: The patients were 24 obese adolescents (age 12–17 yr, 11 boys); four patients withdrew.

Intervention: Intervention was sibutramine (Meridia) or placebo in combination with an energy-restricted diet and exercise plan for 12 wk, followed by an identical, but medication-free, treatment period (follow-up).

Main Outcome Measure: Change in body mass index (BMI) SD score (BMI-SDS) was the principal measure of efficacy. Body composition and total energy expenditure were measured by stable isotopes and further calculated according to the four-component model, using underwater weighing and dual x-ray absorptiometry. Basal metabolic rate (BMR) was measured by ventilated hood and adjusted for sex and body composition (BMR_adj).

Results: After intervention, the decrease in BMI-SDS was comparable in both groups. During follow-up, BMI further decreased in the placebo group but stabilized in the sibutramine group. Changes in the percentage of fat mass were not different between both groups. BMR_adj decreased in the placebo group and remained constant in the sibutramine group. During follow-up, BMR_adj decreased in the sibutramine group and increased in the placebo group. Changes in total energy expenditure were not significantly different.

Conclusion: The effect of sibutramine on BMI-SDS was not significant. Sibutramine may diminish the decrease in BMR_adj associated with energy restriction in obese adolescents.

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				P. Danielsson, A. Janson, S. Norgren, and C. Marcus Impact Sibutramine Therapy in Children with Hypothalamic Obesity or Obesity with Aggravating Syndromes J. Clin. Endocrinol. Metab., November 1, 2007; 92(11): 4101 - 4106. [Abstract] [Full Text] [PDF]