Review: fluoxetine, orlistat, and sibutramine modestly reduce weight in type 2 diabetes.

M e t h o d s Data sources: Studies were identified by searching MEDLINE (1966 to September 2002), EMBASE/Excerpta Medica (1974 to September 2002), CINAHL (1982 to September 2002), Web of Science (1981 to September 2002), Biosis (1970 to September 2002), International Pharmaceutical Abstracts (1970 to September 2002), the Cochrane Library (Issue 3, 2002), the Cochrane Register of Controlled Trials (Issue 3, 2002), key journals, and bibliographies of relevant studies; and by contacting experts and drug manufacturers. Study selection and assessment: Published and unpublished studies in any language were selected if they used pharmacotherapy as the primary strategy for weight loss in patients ≥ 18 years of age with type 2 diabetes and had weight as an outcome. The drugs evaluated were centrally acting appetite suppressants, drugs with a peripheral effect on appetite, drugs that affect nutrient partitioning, and drugs that increase thermogenesis. Drugs that have been withdrawn from the U.S. market or are not available in the United States, investigational drugs and dietary supplements, and metformin and acarbose were excluded. Studies were assessed for quality, including method of randomization, allocation concealment, blinding, intention-to-treat analysis, and attrition. Outcomes: Changes in weight and glycated hemoglobin levels.