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 The increasing prevalence of overweight and obesity in the United States and the corresponding incidence of obesity-related comorbidities underscore the need for preventing and treating obesity rather than focusing solely on its associated health risks. As we know from the literature, obesity is closely associated with the increasing risk of a number of complications that can occur alone or concomitantly. These include hypertension, dyslipidemia, cardiovascular disease, stroke, type 2 diabetes, gallbladder disease, respiratory dysfunction, gout and osteoarthritis. And there are still others — certain cancers, for example.41 Chronic diseases, such as type 2 diabetes, hypertension and hypercholesterolemia, are frequent consequences of obesity. Data from the National Center for Health Statistics' Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994) show that 65% of overweight and obese adults (BMI > 27) have at least one of these chronic diseases, and 27% have two or more.16 The following chart shows the impact of these obesity-related comorbidities grows as patients gain weight; the risk of occurrence, prevalence and severity of these comorbidities are, in general, positively correlated with BMI.39,54,70 Epidemiological studies have found a curvilinear relationship between body weight and increasing risk of both mortality and morbidity. In fact, comorbid chronic disease is the major risk.13 
Type 2 Diabetes and Obesity NHANES III found that approximately 12% of persons with a BMI of 27 or greater have type 2 diabetes.16 Of the medical conditions commonly termed "diabetes," type 2 is by far the most prevalent; it accounts for 85% to 90% of the diabetic population.55 Obesity is a major risk factor for type 2 diabetes.12,14 In fact, as many as 80% of these diabetic patients are obese.24 Relative risk of acquiring type 2 diabetes also increases with increasing BMI in adults of both sexes.12,14,33 The following chart is from a study of a large cohort of women aged 30 to 55. The age-adjusted relative risk for type 2 diabetes — when compared with risk in those with a BMI of <22 — was 15.8 for those with BMI 27.0 to 28.9 and 40.3 for those with BMI 31.0 to 32.9. Women with a BMI of 35.0 or greater were actually over 93 times more at risk for developing the disease.14 Moreover, African Americans, particularly those who are older and have a higher BMI, are at increased risk. 6 
Adapted from Colditz, et al.14 The figure below shows that weight loss with XENICAL plus diet improved glycemic control and decreased the rise of sulfonylurea. Efficacy and safety was demonstrated in a 1-year study of obese type 2 diabetics on sulfonylureas (n=321)28 
The long-term effects of XENICAL (orlistat) on morbidity and mortality associated with obesity have not been established. Health Benefits of Weight Loss: Type 2 Diabetes Managing Patients with Obesity-Related Comorbidities | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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