Effective fuling (Poria Cocos) for the treatment of obesity?

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dl, HDL<40mg/dl for men and 50mg/dl for women, systolic blood
pressure>130mmHg or diastolic blood pressure>85mmHg and fasting
plasma glucose>100mg/dl.
Obese patients are often a dyslipidemia characterized by
hypertriglyceridemia, lowering cholesterol and increased HDL LDL.
This metabolic prole is present the most often in obese patients with
accumulation of intra-abdominal fat, which has been associated with
increased risk of ischemic heart disease (IHD).8 It is estimated that,
in Europe, the prevalence of obesity is 10-25% in most countries,8 in
the US of 30.5%9 and in Portugal have 38.6% of adults overweight
and 13.8% are obese.10 In addition, also the alarming increase of
overweight and obesity in the young in our country,11 seem to justify
launching projects aimed at better understanding of these diseases and
the promotion of measures aimed at combating it. The XENDOS12
is the largest study to date with a drug for weight loss. Among the
various studies which demonstrate a reduction in weight, the more
effective is the Orlistat at a rate of 30% in the prevention of absorption
of fat ingested at a dose of 120mg three times a day.13,14 Thus, this
study will seek to verify whether it is really effective use of Poria
Cocos in obesity compared with Orlistat.
Chapter 1 - Obesity, what is it?
Obesity is a multifactorial chronic disease,15 where in the natural
fat reserves increases to the point at which it becomes associated
with other health conditions or increased mortality. It is the result of
positive energy balance, i.e, food intake exceeds energy expenditure.
Although it is an individual clinical condition, increasingly becomes
a public health problem. It is characterized also as a matter of
aesthetic and psychological nature, besides being a great risk to
health. All human beings have caloric needs are to be eliminated
properly, in order to provide its vital function. People with a history of
malnutrition are susceptible to deciencies in fat oxidation, hindering
lipolysis, accumulating them. In the past these diseases were found
in adults. However now, it is also identied in children, especially
the introduction of the diets of fast-food food. Obesity is a current
topic, and may become the most common health problem of the
21st century.16 Evidence suggests that the problem is getting worse
quickly, and the fact that obesity is closely associated with different
chronic conditions means that we are facing a huge challenge to the
system of health care. In Europe, the prevalence of obesity has tripled
in the last two decades.
Chapter 2 - Current solutions
In Pharmacology: The primary treatment for obesity is to reduce
body fat by means of an adequate diet and increased exercise. Diet
and exercise programs produce an average loss of approximately 8%
of the total weight. Not all are pleased with these results, but even the
loss of 5% can signicantly contribute to health. More difcult than
losing weight is to maintain the reduced weight. Between 85% and
95% of those who lose 10% or more by weight recover all the weight
lost within two to ve years.17 The body has systems that maintain their
hemostasis in certain xed points. When people come with obesity
are encouraged to start a calorie reduction diet program, exercise
and behavioral interventions that have a realistic goal weight loss. If
there is no success in these changes, the pharmaceutical therapy is
recommended to include: sibutramine, phentermine, diethylpropion,
uoxetine, bupropion or the most common, Orlistat. When people
come morbid obesity are encouraged to perform bariatric surgery.
In Chinese medicine: Looking rebalance the physical elements using
ancient techniques, seeking to combat obesity in conjunction with
the adoption of a balanced diet. For in Traditional Chinese Medicine
(TCM), obesity corresponds to Qi stagnation, a result of an irregular
diet and emotional state that occurs while the individual feeds.18
For MTC 5 elements inuence the earning capacity and weight
loss, as it governs the energy imbalance. It is known that both a
deciency of Qi and Yang of the Spleen/Pancreas or Qi deciency
and Kidney Yang result in obesity.
MTC contextualizes stating that food is the energy needed to
nourish the body, and this keeps the blood circulating. As the transport
of Qi, the blood carries nutrients that will nourish the body. When
this nutritious energy is in disharmony, there is binge eating, as a
compensatory form of perverse energy, which leads to anger, fear,
anxiety, nervousness, or anxiety.19
Chapter 3 - Etiology, pathophysiology and
syndromes
In ERM obesity can be divided into 4 major syndromes.
1º- Excess Stomach and Spleen
2º- Heat in the Stomach with disabilities Spleen/Pancreas
Int J Complement Alt Med. 2018;11(6):380‒385. 380
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Effective fuling (Poria Cocos) for the treatment of
obesity?
Volume 11 Issue 6 - 2018
Luis Carlos Mendes
Fundacion European Medical Tradicional China, Portugal
Correspondence: Luis Carlos Mendes, Fundacion European
Medical Tradicional China, Portugal, Tel +351916089963,
Email
Received: November 10, 2016 | Published: November 21,
2018
International Journal of Complementary & Alternative Medicine
Book Review Open Access
Introduction
Obesity is a chronic disease that currently constitutes one of the
major health problems of modern societies. In recent decades there
has been an increase in the average weight of the population, as well
as the prevalence of the number of obese individuals.1‒6 Obesity is
associated with an increased prevalence of diabetes, hypertension,
dyslipidaemia, hyperuricaemia, and gallbladder lithiasis. Waist
circumference is now considered one of the main factors for the
diagnosis of metabolic syndrome. According to the latest classication
proposed by the International Diabetes Federation 7 are diagnostic
criteria circumference of the upper waist 94cm for European and
80cm men for European women, triglycerides greater than 150mg/

Effective fuling (Poria Cocos) for the treatment of obesity? 381
Copyright:
©2018 Mendes
Citation: Mendes LC. Effective fuling (Poria Cocos) for the treatment of obesity? Int J Complement Alt Med. 2018;11(6):380‒385.
DOI: 10.15406/ijcam.2018.11.00430
3º- deciency of Qi and Spleen/Pancreas and Kidney
4º- Obesity Congenital
1º- Excess stomach and spleen
Etiology and pathophysiology: In this type people are obese, but
otherwise healthy, disease, and a hearty appetite, but due to the eating
habits and diet of people in Western countries, there is an excess of
nutrition, either in quantity or in quality, and a kind of constitution
that predisposes to this kind of imbalance. The Western diet is rich in
substances such as cheese, bread and meat. They eat large quantities
of food and become, in most cases, an irregular diet. The West as the
last meal too late and extends to long. Moreover, there is no ingrained
habit of exercise and particularly at this late time, Western lies down
following the meal, which facilitates the transformation of fat diet. It
is also veries the absence of the practice of a proper exercise that best
helps you metabolize lipids. It can also be called obesity acquired by
its association with lifestyle and type of social life. This kind of people
always lives on the border between the healthy condition and obesity,
so when they cease to be careful, very easily cease to be healthy.
Associated symptoms
i. Excess body fat, but well distributed proportionally.
ii. Muscle tone with a regular, without sagging, with good
tightness on the skin and muscle when pressed.
iii. Easily present excessive habits of alcohol, especially beer.
iv. Reddened face and easy sweating with constipation and
aversion to heat.
v. Normal language or slightly reddish, with ne or yellowish
cover and sliding Pulse and strong
2º- Heat in the Stomach with disabilities Spleen/
Pancreas
Etiology and pathophysiology: In this type people have mental
problems, emotional disorders, depression, stress, etc ... In a follow-
up of the previous type, to not being treated properly; the situation
causes damage to the spleen and makes poor digestion. Continued
stress causes stagnation of Liver Qi and direct aggression to the
spleen/pancreas, causing appetite but increases digestion capacity
(processing and transport of the essence of food) decrease. In the West
people when with emotional problems tend to show a good appetite or
an overactive appetite, eating to relax and the more eat more relaxed.
Derived from the stagnation of the Liver Qi, which turns into heat or
re, which in turn transmits to the stomach causing re of the stomach,
the person feels relieved, albeit briey, when consuming food. Another
problem is insomnia. After an excess of concern people tend to get up
in the night, and look for foods that satiate excessive appetite, which
makes get fat more easily. In this type, Spleen deciency is the main
factor because it causes poor processing and transport of moisture-
phlegm and body uids, piling up. These people have moisture and
void of Qi, despite eating well, they feel tired, because what they eat
does not become food for energy functions of the body, accumulating
in moisture-mucus leaving the entire system increasingly slow and
stopped.
Associated symptoms
i. Excessive appetite with abdominal distention and epigastric
ii. Weariness, fatigue and lack of energy
iii. Irregular bowel movement, loose stools or constipation
iv. Red tongue, greasy yellow coat and thick, rope Pulse, thin
and sliding
3º- Decient Qi of spleen and kidney
Etiology and pathophysiology: In this type presents many
consequences of years of physical stress, mental, or associated
with problems such as hypothyroidism or diabetes mellitus, or after
depression caused by endocrine deciencies, all because the vitality
of the kidney decreased at a faster pace than normal. In this case,
the decline in internal energy of the organs (spleen and kidney)
and endocrine deciency are those that cause major symptoms, as
are those that manage the energy acquired, inherited and contribute
to the maintenance of the Yuan Qi. These are people who have
normal appetite, but as the weakness is in the metabolism of liquids,
processing and transport of moisture and body uids, more, kidney
managing not make the selection of expulsion of liquid ... these just
accumulated between the skin and muscles. Contrary to what happens
in the rst type, this connective tissue and muscle is soft felt like a
sponge and without force and without tone.
Associated symptoms
i. Normal appetite, pale face, dry skin, and aversion to cold
ii. Willingness to sleep with lack of will power to all
iii. Soft stools or constipation with frequent urination
iv. Pale and swollen tongue, thin white mantle, and thin pulse,
slow and weak.
4º- Obesity congenital
Etiology and pathophysiology: In this type there is obesity since
childhood, considered by MTC, obesity type earth, people, since
children have a constitutional excess body fat, well distributed, having
one or both parents also with excess weight.
Associated symptoms
i. Very good appetite, hyperactivity
ii. Normal language and sliding Pulse and strong
Chapter 4 - medicines
Fu Ling
The Fu Ling was chosen to be a material used commonly by
several professionals in weight loss, although no study or book that
proves its effectiveness for various parts of the world this matter is
used and associated with other in combating obesity.
Synthesizing: This plant is the fungus sclerotia “Poria Cocos (Schw)
Wolf.”
Family Polyporaceae
Properties: It insipid and mildly sweet avor, neutral in nature,
and acts on the heart channels, lungs, spleen, bladder and kidneys.
The absence of taste is to induce diuresis and relieve edema, as the
sweet serves to tone the heart and spleen. It is neutral nature to induce
diuresis without harming the vital Qi, and to tone without drastic
changes, is used for both tone and to disperse.
It is an important matter for edema, catarrh moisture retention. It

Effective fuling (Poria Cocos) for the treatment of obesity? 382
Copyright:
©2018 Mendes
Citation: Mendes LC. Effective fuling (Poria Cocos) for the treatment of obesity? Int J Complement Alt Med. 2018;11(6):380‒385.
DOI: 10.15406/ijcam.2018.11.00430
also has the effect of strengthening the spleen and reassuring.
Chemical composition: 90% polysaccharides based on glucose.
i. Polysaccharides: paciman, lanostanos.
ii. Acids tetracyclic triterpenes: tumulósico acid, eburicólico
acid and pachímico acid.
iii. ergosterol, colinaglucosa, lipase, protease.
Effects TCM
a) Induce diuresis and inhibits the re absorption of electrolytes
Na, K and Cl from renal tubules.
b) Eliminates heat and humidity
c) Harmonize the Jiao Medio.
d) Eliminates moisture and regulates the metabolism of water.
e) Strengthens the spleen and reduces inammation to disperse
the stasis of heat-moisture.
f) Eliminates phlegm.
g) Reassures the heart and calms the Shen.
Effects in pharmacology:
i. Diuretic effect: inhibits reabsorption of electrolytes in the
renal tubules and increases the volume of urine reaches the
bladder and empties it.
ii. Anti-inammatory effect: on diuresis, eliminates the
retained liquid, removing edema, and removing moisture
reducing inammation by uid retention.
iii. Toning effect: improves digestion and digestive functioning.
iv. Tranquilizing effect: as often excess electrolyte reserves is
responsible for psychiatric disorders by stimulating diuresis
and inhibit these electrolytes, and draining them, reduces
pathogens, reassured the body.
v. Effect of lipid Hypo: a liquid eliminate reduce inammation
reduce accumulation of lipids in the blood stream, reducing
the existing cholesterol level.
vi. Hypoglycemic effect: it favors the elimination of liquid and
glucose, which substantially reduces glucose levels in the
blood.
vii. Hypertensive effect: by facilitating diuresis and the
elimination of electrolytes, relaxes the heart and lowers blood
pressure.
viii. precautions: Contraindicated in polyuria in spermatorrhea,
and prolapses of genitals.
General information: Retention of body uids, phlegm retention
(TAN), oliguria, edema, insomnia, palpitations, diarrhea and bloating,
difculty urinating, joint inammation, BI syndrome, agitation,
nervousness and restlessness.
Modern research: Poria has a diuresis effect and may increase the
excretion of sodium, chloride, potassium and other electrolytes,
pachyman socclaride pohy. It would have the effect of enhancing
humoral immunity, tranquilizer, reducing the sugar level in the blood
and intraocular pressure. In modern times, Poria is widely used in
clinical practice for the combined treatment of cancer.
Orlistat
If Fu Ling has no study in this area, will the Orlistat is one of
the leaders in this respect. XENDOS is the largest and longest study
to date with a drug for weight loss. This study showed that weight
loss with Orlistat reduces by 37%. Compared with the observed only
with a change of lifestyle, treatment with Orlistat gave a weight loss
signicantly longer and improving the cardiovascular risk factors
(including blood pressure and lipids). The study also conrmed the
safety in the long run. Wirth also published in 2005 a study on the
reduction of excess weight with orlistat, held in health centers, in order
to compare the results obtained in hospitals. In this study, the results
proved to be similar to other accomplished. A total of 87% of patients
had a reduction of at least 5% by weight and 51% a reduction of at
least 10%, with no signicant differences between men and women.
Briey: Orlistat is produced by Streptomyces toxytricini, having the
property of preventing the action of lipases of all intestinal and thus
decrease the absorption of fat.
Quimica Formula: C29H53NO5
Molar mass: 495.71 g mol -1
IUPAC name: (S) - ((S) -1 - ((2S, 3S) -3hexyl-4-oxooxetan-2-yl)
tridecan-2-yl) -2-formamido-4-methylpentanoate
Action and statement: It is used to treat obesity. It acts in the digestive
system, preventing about one third of the fat from the food you eat
from being digested. Orlistat binds to enzymes of the digestive system
(lipases) and prevents them from breaking down of the fat in the meal
ingested. The undigested fat cannot be absorbed and eliminated by the
body. Orlistat is indicated for the treatment of obesity, in conjunction
with a diet low in calorie intake and for the preparation in surgery in
cases of morbid obesity.
Positive effects
a. Reduces the amount of fat absorbed in the intestine.
b. Weight loss up to 10% at 6 months and reducing LDL
Negative effects
a) Gastrointestinal problems, kidney
b) diarrhea or fecal incontinence, abdominal pain, atulence
c) Reduced levels of fat-soluble vitamins with Headache
Chapter 5 - study
Purpose
a) Evaluate the effectiveness of Poria Cocos to treat obesity.
b) Compare the effects of Orlistat with Poria Cocos in the obe-
sity diagnostic criteria
Variables to be measured
If you will measure the following variables
Efcacy variables
A. The drug efcacy rate after the end of the study: effective,
recommended, recommended some without effect.
i. Effective: it means that all diagnostic criteria improved
ii. Recommended: means some diagnostic criteria and
improved others remain.
iii. Little recommended: it means that some diagnostic criteria
and improved others worsened.
iv. No effect: it means that some diagnostic criteria remained
and others got worse or worse all.
B. The time it took to diagnostic criteria evolve effectively.

Effective fuling (Poria Cocos) for the treatment of obesity? 383
Copyright:
©2018 Mendes
Citation: Mendes LC. Effective fuling (Poria Cocos) for the treatment of obesity? Int J Complement Alt Med. 2018;11(6):380‒385.
DOI: 10.15406/ijcam.2018.11.00430
C. The speed of the actual changes in diagnostic criteria.
Safety variables
Adverse effects: To register any adverse effect, such as malaise,
nausea, fever, arthralgia, rash, headache and more widespread and
severe as a result of treatment, which can result in death, be signs of
life-threatening cause a toxic response, anaphylaxis, or discontinuation
of treatment
Temporality and duration of the study
From 1 October 2014 to 31 March 2015. A total of six months.
In the rst week, the medical specialist will evaluate the patient and
sign the consent informing about the study and the use of their data
collecting variables in CDR.
Each patient will have a table where you put the data collected after
making a blood test and taken measures. Taking drugs is daily, and
every Monday of the week, will be measured the diagnostic criteria
in consultation by the specialist physician. If there are no adverse
reactions and there is no exclusion criterion or this withdrawal, it will
deliver the drugs to take during the following week.
Selection criteria
If include people of all ages diagnosed with obesity with the
following diagnostic criteria:
i. Circumference of the upper waist 94cm to 80cm and European
men to European women,
ii. triglycerides above 150mg/dl,
iii. HDL <40mg/dl for men and 50mg/dl for women,
iv. Systolic blood pressure>130mmHg or diastolic blood
pressure>85mmHg,
v. Fasting plasma glucose>100mg/dl.
Withdrawal criteria: the patient may leave treatment or deny the use
of your data at any time of it. Exclusion criteria excluded people with
other health problems than those associated with obesity, described
above, and/or use any drugs than indicated in your group.
Intervention description
In this study the drugs used have the following description
Name: Poria Cocos (Schw.) Wolf. Or Pachyma Hoelen Rumph
Name in Pinyin: Fu Ling
Scientic name: Poria, Hoelen
Features: Dry mushroom, Concentration 5:1, Green Nature Co., Ltd.
Lot number 32147
Dosage and quantitative description: Package 100gr, daily dose
recommended by the brand 18gr per day (6gr - 3 x day), 99% of Poria
Cocos and 1% maltodextrin
Qualitative test: GMP Certicate
Group control: ratiopharm Orlistat 120mg - 1 dose 3times per day.
Clinical trial
There were records of the measures at baseline. Serum
concentrations of HDL-cholesterol and triglycerides were analyzed.
Glucose and measured blood pressure was recorded. It was prepared
and recorded the record at the beginning and checked and updated
every week. Adverse events were recorded that occurred during the
study as well as their severity and potential relationship to treatment.
Results: We selected 126 patients, and 123 completed the study
criteria. We randomly selected 63 patients for orlistat group and 60
to the Fu Ling group. The people who completed the study included
98 patients (96 Caucasian and Negroid 2) (58 women and 40 men).
25 recorded dropouts (17 adverse events and 8 refusal of
treatment) occurred in the rst 4weeks of treatment, all were women.
The average age of patients was 47.6years. At the time the study
began, the patients’ weight ranged between 66kg and 176kg, with an
average of 99,4kg. The lipid prole showed a mean HDL 39.4mg/dl
and triglyceride levels of 206.5mg/dl. We can see all mean baselines
with minimum and maximum in the tables below.
References: Age (years)-Weight (kg)-Waist (cm)-Glucose (mg/dl)-
HDL cholesterol (mg/dl) - Triglycerides (mg/dl)-Systolic pressure
(mmHg)-Voltage Diastolic (mmHg).
Médias iniciais
Sexo (M/F) Idade Peso Cintura Glicose HDL-C Triglicéridos Sistólica Diastólica
F 47,3 91,8 102,6 177,0 41,2 205,2 153,1 95,5
M 48,4 115,3 124,9 165,6 35,9 209,2 154,0 96,3
Total 47,6 99,4 109,9 173,3 39,4 206,5 153,4 95,7
Máximos iniciais
Sexo (M/F) Idade Peso Cintura Glicose HDL-C Triglicéridos Sistólica Diastólica
F 82 171 155 312 49 292 196 128
M75 176 184 278 39 312 185 124

Effective fuling (Poria Cocos) for the treatment of obesity? 384
Copyright:
©2018 Mendes
Citation: Mendes LC. Effective fuling (Poria Cocos) for the treatment of obesity? Int J Complement Alt Med. 2018;11(6):380‒385.
DOI: 10.15406/ijcam.2018.11.00430
Mínimos iniciais
Sexo(M/F) Idade Peso Cintura Glicose HDL-C Triglicéridos Sistólica Diastólica
F 18 66 81 101 34 151 132 87
M 23 78 96 107 29 153 131 86
Médias iniciais por grupo
Grupo População Peso Cintura Glicose HDL-C Triglicéridos Sistólica Diastólica
Fu Ling 60 98,9 110,2 173,4 39,8 205,9 154,9 96,7
Orlistato 63 99,9 109,6 173,2 39,2 207,1 151,9 94,8
Between the initial visit and the fourth week, there was a signicant
difference in reducing the weight and waist, as in the tables below.
Diferença na perca
de peso Fu Ling–n=55 Ortistato–n=43
Inicio – 4ª semana Média=94.5(-4.4) Média=98.1(-1.8)
Inicio –6 meses Média=84.2(-14.7) Média=93.8(-6.1)
Diferença na cintura Fu Ling – n=55 Ortistato – n=43
Inicio –4ª semana Média=103.5(-6.7) Média=101.8(-7.8)
Inicio – 6 meses Média=85.6(-24.6) Média=98.4(-11.2)
We evaluated the average weight reduction in patients in
consecutive visits. Weight reductions were different. With a weight
reduction of 4.4kg and 1.8kg for Fu Ling and Orlistat group, and waist
of 6.7cm and 7.8cm, respectively.
After the treatment period (6months), we found there is a signicant
mean reduction in weight of the Orlistat group 6.1kg and 14.7kg of the
Fu Ling group, while the waist orlistat group only reduced in 5months
and 3.4cm Fu Ling 17,9cm an impressive group on average in the
same period of time.
We can check all the average nal values, with minimum and
maximum in the tables below.
Médias nais por grupo
Grupo População Peso Cintura Glicose HDL-C Triglicéridos Sistólica Diastólica
Fu Ling 55 84,2 86,4 125,4 45,7 167,4 138,9 84,3
Orlistato 43 93,8 101,6 168,1 45,5 208,3 131,4 80,2
Máximos nais por grupo
Grupo População Peso Cintura Glicose HDL-C Triglicéridos Sistólica Diastólica
Fu Ling 55 133 131 178 64 194 168 104
Orlistato 43 161 173 269 61 338 147 111
Mínimos nais por grupo
Grupo População Peso Cintura Glicose HDL-C Triglicéridos Sistólica Diastólica
Fu Ling 55 51 71 75 41 97 96 69
Orlistato 43 59 76 91 40 138 91 64
Of changes in HDL levels were similar between groups, with
an increase of about 15%. But no signicant differences in glucose
values and triglyceride levels among groups.
The population administered by Fu Ling showed glycemia values
with 72.3% of the initial value, while the remaining population had
97% of its initial value.
If the reduction in blood glucose was minimal with the Orlistat
group, since the Triglyceride showed values of 0.6% over the initial,
resulting in a very negative aspect to take into account in the nal
assessment, given the decrease to 81% of the initial value in the group
Fu Ling.
In the blood pressure difference was reduced in both, although
slightly more pronounced in the group Orlistat.
Side Effects: The overall incidence of adverse events was higher in
orlistat group compared to the group Fu Ling.
Efeitos secundários (ES) Fu ling Orlistato
Paciente com ES 3 15
Paciente sem ES 55 43
The number of patients with gastrointestinal disorders only existed
in the orlistat group.
There were 17 dropouts for side effects: abdominal pain, profuse
watery stools and diarrhea, and dizziness.
In Fu Ling group, 3 people left the study dizzy.
Comparison of results
This study, conducted in the Portuguese population, with 6-month
controlled Orlistat revealed that Fu Ling, was effective in obesity in
both weight loss and improving the values of the lipid prole, blood
pressure and glucose. The study was able to demonstrate the existence
of a signicant difference in reducing obesity among the Fu Ling and
Orlistat.
At the end of the treatment period there was an average decrease
in initial weight of 6.1kg in the orlistat group and 14,7kg in Fu Ling
group, with the greatest reduction occurred during the rst few weeks.
The Orlistat group showed a negative increase in triglycerides
values and an increase in HDL. In the Fu Ling group showed a positive
reduction in triglycerides and an increase in HDL, which beneted the
lipid prole.

Effective fuling (Poria Cocos) for the treatment of obesity? 385
Copyright:
©2018 Mendes
Citation: Mendes LC. Effective fuling (Poria Cocos) for the treatment of obesity? Int J Complement Alt Med. 2018;11(6):380‒385.
DOI: 10.15406/ijcam.2018.11.00430
Conclusion and recommendation
Conclusion
In conclusion, the weight reduction and the improvement in the
lipid prole observed in patients treated with Fu Ling suggest that this
matter is benecial in the early treatment of obesity.
Although several studies have shown that treatment with orlistat
results in combat will signicantly obesity, this study proved that with
Fu Ling this ght is even greater, and it is expected that associated
with a proper diet each case, this value may be higher.
Recommendation
After the study was sure that the use of Fu Ling is critical in
combating obesity will, however, be presented values that still show
more suggestions that require their study. The reduction of blood
sugar and triglycerides is something important in the tables of today
in clinic. The difference between men and women was notorious with
men to lose more weight long term and women to cast down over
earlier. As weight loss was most pronounced in active people, and
reducing the waist in unemployed and retired people. It is suggested
their study after the results presented in this study.
Acknowledgements
None.
Conict of interest
Author declares that there is no conict of interest.
References
1. Chan JM, Rimm EB, Colditz GA, et al. Obesity, fat distribution, and
weight gain as risk factors for clinical diabetes in men. Diabetes Care.
1994;17(9):961‒969.
2. Colditz GA, Willett WC, Rotnitzky A, et al. Weight gain as a risk
factor for clinical diabetes mellitus in women. Ann Intern Med.
1995;122(7):481‒486.
3. Carey VJ, Walters EE, Colditz GA, et al. Body fat distribution and risk
of non-insulin-dependent diabetes mellitus in women. The Nurses’
Health Study. Am J Epidemiol. 1997;145(7):614‒619.
4. Van Itallie TB. Health implication of overweight and obesity in the
United States. Ann Int Med. 1985;103(6 Pt 2):983‒988.
5. Garnkel L. Overweight and cancer. Ann Int Med. 1985;103:1047‒1052.
6. Kluther R, Schubert A. Obesity in Europe. Ann Int Med.
1985;103:1043‒1047.
7. The IDF consensus worldwide denition of the metabolic syndrome.
2006:1‒7.
8. Obesity: Preventing and managing the global epidemic. Report of a
WHO Consultation on obesity. 2000. 252 p.
9. National Health Examination Surveys. Endocrinol Metab Clin N Am.
2003.
10. Carmo I, Santos O, Camolas J, et al. Prevalence of obesity in Portugal.
Obes Rev. 2006;7(3):233‒237.
11. Lacerda Nobre E, Macedo JA, Castro J. Tendências do peso em Portugal
no nal do século XX. Acta Med Port. 2004;17:205‒209.
12. Torgerson JS, Hauptman J, Boldrin MN, et al. Xenical in the Prevention
of Diabetes in Obese Subjects (XENDOS) Study. A randomized study
of orlistat as an adjunct to lifestyle changes for the prevention of type 2
diabetes in obese patients. Diabetes Care. 2004;27(1):155‒161.
13. Sjöstron L, Rissanen A, Andersen T. For the European Multicentre
Orlistat Study Group. Randomized placebo-controlled trial of orlistat
for weight loss and prevention of weight regain in obese patients.
Lancet. 1998;352(9123):167‒172.
14. Davidson MH, Hauptman J, DiGirolamo M, et al. Weightcontrol and
risk factor reduction in obese subjects treated for 2years with orlistat. A
randomized controlled trial. JAMA. 1999;281(3):235‒242.
15. Guanabara Koogan. Obesidade: etiologia e classicação. In: Dâmaso
A, Tock L. Obesidade: Perguntas e respostas. Rio de janeiro;
2005;3:21‒26.
16. Oliveira RGA. Obesidade na infância e adolescência como fator de
risco para doenças cardiovasculares do adulto. Instituto Danone;
2000;6:65‒76.
17. Bouchard C. Actividade física e obesidade. 2003;3:3‒22.
18. Yanze Liu, Zhimin Wang. Dietary Chinese Herbs. 2015:781‒788.
19. Rita Catarino. Abordagens farmacoterapêuticas no tratamento da
Obesidade. 2011.