A commonly prescribed inhibitor of fat absorption called orlistat neither helps patients with fatty liver disease (FLD) lose weight nor improve their liver enzymes or insulin resistance, according to a new study.
The new findings, reported in the journal Hepatology, are based on a new randomised trial.
Weight loss is known to improve liver enzymes and levels of fat in the liver.
The study did show such improvements among the patients who had lost 5 percent or more of their body weight over nine months.
However, since it is often difficult for people to lose weight through diet and exercise, researchers have looked for medications that could help.
U.S. Army hepatologist Stephen A. Harrison, who led the study, has revealed that his team conducted a trial of overweight patients with FLD to determine the effect of orlistat in conjunction with caloric restriction.
He revealed that the randomized, controlled trial included 50 people who had been diagnosed with FLD after clinical evaluation and liver biopsy.
For 36 weeks, all subjects followed a diet of 1400 calories per day, a multivitamin and vitamin E regimen and were randomized to take orlistat.Thereafter, the patients underwent a liver biopsy, and the researchers looked for improvement in fat levels and fibrosis score.
The researchers also monitored changes in biochemical data like fasting insulin and glucose, liver enzymes, lipid panel vitamin E and free fatty acid levels.
"Comparing the orlistat group to the non-orlistat group at study completion, no significant differences were identified between the two groups for mean weight loss, serum, insulin resistance or cholesterol," the authors report.
They also note that there were no significant differences in the liver biopsy findings.
Given the lack of differences between the two groups, the researchers reanalysed the data to compare subjects who lost differing amounts of body weight.
They noted a linear relationship between weight loss and liver improvement. According to them, body weight loss of 9 percent or more resulted in the greatest amount of liver improvement.
"In conclusion, while this preliminary study does not demonstrate a weight loss advantage with the use of orlistat, it does demonstrate that moderate weight loss is associated with significant improvements in the symptoms of FLD," the authors report.