Fluoxetine hydrochloride (Lovan(TM), Eli Lilly and Company, Indianapol
is, Indiana, USA), a specific serotonin uptake inhibitor, was compared
with placebo in 458 obese outpatients in a 52-week double-blind rando
mized ten-site trial to study its effect on weight reduction. Patients
in the fluoxetine and placebo groups were predominantly Caucasian (81
% and 85%, respectively) and female (81% and 79%, respectively), with
a mean body mass index (BMI) of 36.2 and 35.8kg/m(2), respectively, an
d a mean age of 43 years (both groups). Fluoxetine therapy (60 mg/day)
resulted in statistically significantly (P less than or equal to 0.05
) greater mean weight loss than placebo to week 28. Although some pati
ents continued to lose weight throughout the 52-week therapy period, m
aximum mean weight loss occurred at week 20. There was no treatment di
fference at 52 weeks. The change in visit frequency (biweekly to week
8, monthly to week 20, then bimonthly to week 52) may have affected re
sults. Patients with higher baseline BMIs (> 40 kg/m(2)) attained and
maintained a greater weight loss than patients with lower baseline BMI
s (<40 kg/m(2)). Two sites demonstrated greater efficacy than the stud
y as a whole. The use of nutrition counselling at one site and behavio
ur modification at the other, or other site-to-site differences, may a
ccount for the improved efficacy. Fluoxetine was well tolerated and ap
peared to be safe therapy for the treatment of obesity with efficacy d
emonstrated for 28 weeks.