Which drugs are effective for weight loss in adults with type 2 diabetes?

From: The Cochrane Collaboration

Journal rating:
rating: 98%
Study Quality:
rating: 100%

Overall Reliability

Article Quality:
rating: 75%
rating: 50%


  • 22 trials with 3,379 participants


  • The paper is a systematic review / meta analysis of all relevant trials.
  • This means that the data from all similar trials has been grouped together to form an overall outcome.


  • Fluoxetine produced an average weight loss of 5.1 kg at 24 - 26 weeks; orlistat 2.0 kg at 12 - 57 weeks, and sibutramine 5.1 kg at 12 - 52 weeks.
  • Gastrointestinal side effects were common with orlistat; tremor, somnolence and sweating with fluoxetine; and palpitations with sibutramine.
  • A number of weaker trials highlighted a significant decrease in weight with mazindol, phenmetrazine, and phentermine.
  • No suitable studies were identified for pseudoephedrine, ephedra, sertraline, yohimbine, amphetamine or its derivatives, bupropion, topiramate, benzocaine, threachlorocitric acid, sertraline, and bromocriptine.
  • The authors conclude that fluoxetine, orlistat, and sibutramine can achieve statistically significant weight loss over 12 to 57 weeks. However, the amount of weight loss is modest and the long-term health benefits remain unclear. The safety of sibutramine is uncertain. 


  • Yes (with confidence) – for fluoxetine, orlistat, and sibutramine