THE EFFECT OF FLUOXETINE ON BODY-WEIGHT, BODY-COMPOSITION AND VISCERAL FAT ACCUMULATION

In this study the effect of fluoxetine versus placebo treatment on body weight, body composition and abdominal fat areas, assessed from three magnetic resonance imaging scans at umbilicus level, was investigated. Thirty-eight abdominal overweight men aged 41 +/-7 years (mean +/- s.d.), BMI 27.9 +/- 1.2 kg/M2 and WHR 0.97 +/- 0.03 were given dietary advice and a placebo (n = 20) or fluoxetine treatment (n = 18, 60 mg/day) for 12 weeks after a placebo run-in of two weeks. Measurements were carried out during run-in and at week 12 of treatment. The treatment groups did not differ at the start of the study. After treatment, weight loss (on average) was observed in both groups: -2.4 +/- 0.6 kg and 5.9 +/- 0.7 kg for the placebo and fluoxetine groups, respectively. Weight loss was significantly larger in the fluoxetine group (P = 0.0004). The reduction of fat mass tended to be larger (P = 0.08), and the reduction of fat-free mass was considerably larger in the fluoxetine group (P = 0.0005). Absolute (and proportional) changes in visceral and subcutaneous fat areas (cm2) were +2 +/- 26 (+1%) and 9 +/- 26 (-4%) in the placebo group, and 9 +/- 30 (3%) and 30 +/- 27 (-13%) in the fluoxetine group. In both groups the proportional change in subcutaneous fat area was larger than the change in visceral fat (P < 0.02). Only in the fluoxetine group was the decrease in subcutaneous fat area significant, and larger compared to the placebo group (P = 0.02). After adjustment for the decrease in body fat mass the difference between the groups disappeared. These findings suggest that fluoxetine treatment leads to increased weight loss (of which a substantial part consists of fat-free mass) compared to placebo, but not to a selective reduction of visceral fat in abdominal overweight men.