Short-term treatment of obesity with fluoxetine as a supplementary to a low calorie diet

Background: Inhibitors of serotonin re-uptake including fluoxetine have generally been successful in inducing modest but statistically significant weight reductions in clinical trials. However, there are few published trials with serotonin re-uptake inhibitors in obesity therapy on Asians. This study aimed to assess the effect of fluoxetine as an adjunct therapy to a low calorie diet in the obese Taiwanese population. Methods: Sixty healthy obese subjects [body weight > 130% of ideal body weight (IBW)] were instructed to follow a low calorie diet. All subjects were randomized to receive fluoxetine 60 mg once daily with diet or diet only for 12 weeks. Results: The mean total body weight reduction at the end of the study was significantly greater in the fluoxetine group than in the diet group (mean ± S.E., -5.75 ± 0.69 vs. -3.06 ± 0.59 kg, p = 0.008). The body weight reduction in the first 4 weeks and second 4 weeks were greater in the fluoxetine group and they were statistically significant (mean ± S.E., 1st 4 weeks: -2.57 ± 0.34 vs. - 1.24 ± 0.22 kg, p = 0.0033; 2nd 4 weeks: -1.90 ± 0.25 vs. -0.9 ± 0.35 kg, p = 0.0226). In the third 4 weeks, the weight reduction in the fluoxetine group was still greater, but it was not statistically significantly (mean ± S.E., third 4 weeks: -1.21 ± 0.34 vs. -0.73 ± 0.25 kg, p = 0.299). More symptoms of anorexia and nausea were noted in the fluoxetine group. The other side effects noted in the fluoxetine group were usually mild and tolerable. Conclusion: Fluoxetine is effective, well tolerated and relatively safe in the short-term treatment of obesity in the Taiwanese population when added to a low calorie diet.