Orlistat with low carb diet reduces liver fat content in MAFLD patients

A recent study published in The American Journal of Clinical Nutrition found that both orlistat and experimental high-protein/lower-carbohydrate diet were effective in reducing liver steatosis in Asian patients with obesity and Metabolic-associated fatty liver disease (MAFLD). 

Excessive fat accumulates in the liver in MAFLD, leading to inflammation and damage. Losing weight through lifestyle interventions, such as changes in diet and physical activity, is the first-line treatment for MAFLD. However, compliance with such interventions can be low, making it challenging to achieve and maintain weight loss.

The team led by Xiongcai Feng compared the effects of orlistat and an experimental high-protein/lower-carbohydrate diet with a control diet in Asian patients with obesity and MAFLD. A total of 118 patients were enrolled and randomly assigned to one of the three groups for 24 weeks. The primary endpoint of the study was the relative change in liver fat content (LFC), which was assessed by magnetic resonance imaging-based proton density fat fraction with Dixon sequence (MRI-PDFF).

The results showed that all three groups demonstrated improvement in liver steatosis at week 24. However, the orlistat group and the experimental diet group had significantly greater reductions in LFC compared to the control group.

Specifically, the absolute decrease in LFC was 9.1% in the orlistat group and 5.4% in the experimental diet group, both significantly higher than that in the control group.

The relative reduction in LFC was 30.2% in the experimental diet group, which was significantly higher than the 12.2% observed in the control group.

Authors suggest that these interventions could be useful in the management of MAFLD, particularly in populations where compliance with lifestyle interventions may be challenging. However, further research is needed to determine the long-term efficacy and safety of these interventions.

Source:

Feng, X., Lin, Y., Zhuo, S., Zhi, D., Shao, C., Ye, J., & Zhong, B. (2023). Treatment of Obesity and Metabolic-Associated Fatty Liver Disease with a Diet or Orlistat: A Randomized Controlled Trial. In The American Journal of Clinical Nutrition. Elsevier BV. https://doi.org/10.1016/j.ajcnut.2023.02.008