Introduction: Obesity is a growing health problem. Many drugs have been developed to treat obesity. Orlistat is a widely used drug to treat this disease. Metformin is an antidiabetic drug. Clinicians often prescribe it to treat insulin resistance and achieve weight loss. Our research aims to compare the effects of orlistat alone and its combination with metformin on weight loss and insulin resistance. Material and Method: This retrospective study was conducted by scanning the data of patients who presented to Antalya Training and Research Hospital Endocrinology, and General Surgery Clinics between 2016 and 2021. 42 morbidly obese patients who met inclusion and exclusion criteria and were prescribed orlistat plus metformin (group 1, n: 28) or orlistat alone (group 2, n: 14) along with a low-calorie diet for three months and were taking it regularly were included. Subsequently, weight, body mass index, fasting blood glucose, fasting insulin, and HOMA-IR (homeostasis model assessment for insulin resistance) were recorded and analyzed at baseline and after three months of taking the medications. Results: After 3 months of treatment, significant weight loss was achieved in both groups compared to baseline weight (p=0.001 group 1, p=0.003 group 2). HOMA-IR values decreased significantly in both groups (p=0.001 group 1, p=0.01 group 2). Both groups lost the same amount of weight after three months (p=0.06). Conclusion: In morbidly obese patients without prediabetes or diabetes, the addition of metformin to orlistat therapy did not add benefits in terms of weight loss or insulin resistance.
The incidence of obesity is increasing. Thyroid dysfunction has been extensively studied in obesity. The aim of this study is to determine thyroid hormone levels in patients with obesity (Class I and II obesity) and morbid obesity, and to determine the correlation between body mass index (BMI) and thyroid hormones. Material and Methods: Data from one hundred fifty-seven patients with obesity, including 71 patients with a BMI of 30-39.9 kg/m 2 (Group 1) and 86 patients with morbid obesity with a BMI≥40 kg/m 2 (Group 2), and 60 control subjects with a BMI of 18.5-24.9 kg/m 2 were retrospectively reviewed. Thyroid hormone levels were compared. Consent was obtained from the patients and, if necessary, their legal representatives. The study was a retrospective cross-sectional study. Ethics committee approval was obtained for our study. Results: The mean age of obese and normal-weight individuals was similar (p=0.94). Thyroidstimulating hormone (TSH) levels were higher in patients than in controls (3.7±1.8 μIU/mL and 2.5±1.7, respectively; p=0.01). The prevalence of subclinical hypothyroidism (SCH) was higher in patients than in controls (p=0.003). There was a positive correlation between TSH and BMI (r=0.44, p=0.001). In subgroup analysis, TSH level was similar in Group 1 and Group 2 (p=0.07). TSH was higher in Group 1 (p=0.03) and Group 2 (p=0.01) than in the control group. The frequency of SCH was similar in Group 1 and Group 2 (p=0.06). The frequency of SCH was higher in Group 1 (p=0.006) and Group 2 (p=0.002) than in the control group. Conclusion: TSH level was higher in patients with obesity than in healthy controls. There was a positive correlation between BMI and TSH. Thyroid hormone levels were similar in patients with a BMI of 30-39.9 kg/m 2 and morbid obesity. We recommend thyroid hormone screening in obesity.
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