Isfahan, Iran

Author Affiliations: Isfahan Endocrine & Metabolism Research Center (Rezvanian H, Hashemipour M), Pediatric Preventive Cardiology Department, Isfahan Cardiovascular Research Center (Kelishadi R), Isfahan Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran (Tavakoli N); Environmental Engineering, Science & Research University, Tehran, Iran (Poursafa P)

Corresponding Author: Roya Kelishadi, MD, Isfahan Cardiovascular Research Centre, Isfahan University of Medical Sciences, PO. Box 81465-1148, Isfahan, Iran (Tel: +98 311 3377881-8; Fax: +98 311 3373435; Email: Kelishadi@med.mui.ac.ir)

doi:10.1007/s12519-010-0232-x

Background: The efficacy of pharmacological treatment in controlling childhood obesity is controversial. We aimed to compare the effects of three types of drug regimens and placebo on generalized and abdominal obesity among obese children and adolescents who did not succeed to lose weight 3 months after lifestyle modification (diet and exercise).

Methods: This triple-masked randomized clinical trial was conducted among 180 participants aged 10-16 years. They were assigned randomly to 4 groups of equal number to receive metformin, fluoxetine, a combination of the two drugs, or placebo. The trial lasted for 12 weeks and participants were followed up for an additional 12-week period.

Results: Overall, 91.1% (n=164) of the enrolled participants completed the trial. After the 12-week trial, the body mass index decreased significantly in all groups receiving medications [approximately -1.2 (0.2) kg/m², P<0.05]. This decrease was not significant in the placebo group. Waist circumference decreased significantly in the groups receiving metformin [-2.1 (0.4) cm, P=0.03)] as well as in the group receiving a combination therapy of metformin and fluoxetine [-2.5 (0.4) cm, P=0.01)]. In the 24-week follow-up study, these anthropometric indexes were lower than the baseline in the group that had received a combination therapy of metformin and fluoxetine. No serious drug side-effects were reported.

Conclusions: A limited period of such treatment may help weight control, and might be used to encourage those children who have been refractory to weight loss for continuing the non-pharmacological programs. Our findings should be confirmed in future studies with a longer follow-up period.

Key words: abdominal obesity; childhood obesity; fluoxetine; generalized obesity; metformin; treatment

                    World J Pediatr 2010;6(4):317-322