In Asians with MAFLD and obesity, Orlistat was more effective than high-protein/lower-carbohydrate experimental diet and lifestyle intervention in ameliorating liver steatosis.

A randomized controlled trial investigated the impact of Orlistat or an experimental lower-carbohydrate/high-protein diet contrasted to control diet in Asians having metabolic-associated fatty liver disease (MAFLD) and obesity.

A total of 118 individuals with MAFLD and obesity verified by magnetic resonance imaging-proton density fat fraction (MRI-PDFF) with Dixon sequence were recruited and randomly assigned to the control (n = 39), Orlistat (n = 40), and experimental diet (n = 39) groups for 24 weeks. The relative alteration in liver fat content, as determined by MRI-PDFF was the major outcome ascertained.

At week 24, liver steatosis improved in all three groups. The absolute reduction in liver fat content was 9.1% in the Orlistat group and 5.4% in the experimental diet group, both considerably greater when compared to the control group. In comparison with the 12.2% noted in the control group, the relative drop in liver fat content was remarkably greater (30.2%) in the experimental diet group.

Orlistat exhibited superiority over experimental diet and lifestyle changes in lowering the liver fat content in people with MAFLD and obesity who failed to attain improvements in weight after six months of self-lifestyle management.