The prevalence of obesity is increasing worldwide and obesity is an important risk factor for
cardiovascular disease. In addition, back pain has been increasing steadily due to sitting
life, lack of exercise, wrong posture, and obesity. Recent studies found that obesity and
back pain are common diseases and are closely related to each other. People with back pain
have lower physical activity, which in turn leads to an weight gain and a deterioration in
physical performance. Among the drugs used for obesity, orlistat has been approved for
long-term use, and phentermine, the most commonly used drug, has been approved for short-term
use. However, phentermine can increase blood pressure and pulse rate. Meanwhile, several
studies have shown that orlistat, a pancreatic lipase inhibitor, lowers blood pressure and
pulse rate and diminish LDL-cholesterol. Lowering LDL-C could lead to improved vascular
endothelial function.
The investigators aimed to investigate the effect of orlistat and phentermine combination
therapy on weight loss and improvement of vascular function compared to phentermine
monotherapy in obese patients (BMI 27 kg/m2) with metabolic risk and back pain.